Antibiotics of Helicobacter pylori eradication algorithms. What limit our choice of agents?
Abstract
The aim of review. To present characteristics of antibiotics, applicable for H.pylori eradication.
Recent literature data. Antibiotics, along with antisecretory drugs (proton pump inhibitors – PPI), are obligatory components of eradication modes for H. pylori-associated diseases. High efficacy of the first line algorithms including PPIs, amoxicillin and clarithromycin, is proved by a number of randomized clinical tests, metaanalyses of these tests and established by the international consensus meetings (Maastricht consensus I–III). Components of this mode have synergetic effect: at combined application of clarithromycin and omeprazole blood concentration of the latter and its half-life time increase. At concurrent intake of omeprazole clarithromycin shows similar changes of pharmakokinetics that is liner increase of concentration and active metabolism in stomach mucosa and gastric mucus.
Conclusion. Efficacy of this treatment, confirmed by high, over 80%, H. pylori eradication rate, safety and good tolerability, is caused by synergism between components of the mode, first of all between PPI and clarithromycin.
References
1. Дехнич Н.Н., Козлов С.Н. Кларитромицин (клацид) – роль в эрадикации Helicobacter pylori-инфекции // Фарматека. – 2007. – № 13. – С. 1–6.
2. Захарова Н.В. Комбинированная схема эрадикации Helicobacter pylori // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2006. – Т. 16, № 3. – С. 45–51.
3. Исаков В.А., Домарадский И.В. Хеликобактериоз. – М.: Медпрактика-М, 2003. – 412 с.
4. Подгорбунских Е.И., Маев И.В., Исаков В.А. Фромилид – обязательный компонент первой линии кислотозависимых заболеваний, ассоциированных с Helicobacter pylori // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2002. – Т. 12, № 5. – С. 87–92.
5. Рациональная фармакотерапия заболеваний органов пищеварения: Руководство для практикующих врачей / Под общ. ред. В.Т. Ивашкина, Т.Л. Лапиной и др. – М.: Литтерра, 2003.– С. 147.
6. Gisbert J.P., Gonzalez L., Calvet X. Systematic review and meta-analysis: proton pump inhibitor vs. ranitidine bismuth citrate plus two antibiotics in Helicobacter pylori eradication // Helicobacter. – 2005. – Vol. 10, N 3. – P. 157–171.
7. Gustavson L., Kaiser J.F., Edmonds A.L. et al. Effect of omeprazole on concentrations of claritromycin in plasma and gastric tissue at steady state // Antimicrob. Agents Chemother. – 1995. – Vol. 39, N 9. – Р. 2078–2083.
8. Kim B.G., Lee D.H., Ye B.D. et al. Comparison of 7-day and 14-day proton pump inhibitor-containing triple therapy for Helicobacter pylori eradication: neither treatment duration provides acceptable eradication rate in Korea // Helicobacter. – 2007. – Vol. 12, N 1 – P. 31–35.
9. Koivisto N.N., Rautelin H.J. Voutilainen M.E. First-line eradication therapy for Helicobacter pylori in primary health care based on antibiotic resistance: results of three eradication regiments // Aliment. Pharmacol. Ther. – 2005. – Vol. 21, N 6. – P. 773–782.
10. Malfertheiner P., Megraud F., O’Morain C. et al. Current concepts in the management of Helicobacter pylori infection – The Maastricht III Consensus Report // Gut. – 2007 [Epub ahead of print].
11. Sullivan B. et al. Azithromycin is not effective for eradication of Helicobacter pylori // Am. J. Gastroenterol. – 2002. – Vol. 97. – P. 2536–2539.
12. Wei-Hao Sun, Xi-Long Ou, Da-Zhong Cao et al. Efficacy of omeprazole and amoxicillin with either clarithromycin or metronidazole on eradication of Helicobacter pylori in Chinese peptic ulcer patient // World J. Gastroenterol. – 2005. – Vol. 11, N 16. – P. 2477–2481.
Review
For citations:
Samsonov A.A. Antibiotics of Helicobacter pylori eradication algorithms. What limit our choice of agents? Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(4):63-68. (In Russ.)
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