Behandeling van Helicobacter pylori-infectie

H. pylori infection is a very common infection of the human stomach, related to various diseases such as gastritis, ulcerative disease of the duodenum and stomach, mucosa associated lymphoid tissue lymphomas and gastric cancer. It is generally accepted that the majority of related diseases is curable once H. pylori infection is successfully eradicated. H. pylori eradication will only be achieved after administration of combination therapies including antibiotics and antacids. Resistance to metronidazole and clarithromycin is an emerging problem, leading to impairment of eradication efficacy, irrespective of the regimen administered. Eradication regimens consisting of three or four anti-H. pylori drugs are the most efficacious. Given the easy use and high convenience to the patients and the high efficacy, 1-week proton pump inhibitor (PPI)-triple therapy is preferred as the first-line therapy. Alternatively, bismuth triple therapy or the combination of antacids and bismuth triple therapy can be prescribed; however, these regimens are less convenient to the patients, the course is prolonged or the side effects occur more frequently compared with PPI-triple therapy