Improvement methods of eradication therapy effectiveness

G.R. Bikbavova, V.A. Akhmedov, B.M. Mukhamedzhanov

Omsk State Medical University

Currently, an eradication therapy conducting is a crucial way of stomach malignant tumors prevention in patients having a history with signs of chronic gastritis, gastric and duodenal ulcer, as well as other diseases associated with Helicobacter pylori. The article deals with the aspects of this causative agent resistance to various antibiotics used in eradication therapy regimens around the globe. Based on the latest data, the main rules that will contribute to the eradication therapy effectiveness are presented: application of proton pump inhibitors large doses; sensitivity determination to the antibacterial drug, if it was used previously; shift of the previously used eradication therapy regimen. It was noted that the most optimal regimen is quadruple therapy with bismuth in regions with high resistance to antibacterial drugs or after unsuccessful triple regimen application with clarithromycin/levofloxacin, as well as in patients  having in history the data on the macrolides and quinolones use. The triple regimen with clarithromycin is recommended in patients with a low resistance to this drug (<15%), while treatment duration should be increased up to 14 days. The sequential regimen application is currently not actively recommended.

Keywords: eradication therapy, Helicobacter pylori, antibiotic resistance, effectiveness improvement.

For citation: Bikbavova G.R., Akhmedov V.A., Mukhamedzhanov B.M. Improvement methods of eradication therapy effectiveness. RMJ. 2019;7:6–10.