Author/Editor | Tepeš, Bojan; Gubina, Marija | |
Title | Razlogi za neuspeh antimikrobnega zdravljenja okužbe z bakterijo Helicobacter pylori in naše terapevtske možnosti | |
Translated title | Reasons for therapeutical failure in treatment of Helicobacter pylori infection and therapeutic possibilities | |
Type | članek | |
Source | Zdrav Vestn | |
Vol. and No. | Letnik 73, št. 6 | |
Publication year | 2004 | |
Volume | str. 503-6 | |
Language | slo | |
Abstract | Background. Helicobacter pylori infection is the main cause of gastritis, gastric and duodenal ulcer and MALT lymphoma. Bacteria is also recognised as a risk for the development of gastric cancer. More than half of the world population and also Slovenian population is infected with H. pylori. Bacteria causes serious diseases only in about 20% of intected who are candidates for the eradication therapy. The basic therapeutic combination is a proton pump inhibitor with two antibiotics. Because of the emerging bacterial resistance to antibiotics we are forced to find new therapeutical possibilities. The main reasons for therapeutic failure are described in the article as well as data for antimicrobial resistance in Slovenia. Conclusions. Recommended management strategies in Europe and in Slovenia are described. Eradication success is lower than it was and we should always test for successfiel eradication by urea breath test or endoscopic based tests if endoscopy is clinically indicated. Management strategies in case of therapeutical failure are also described. | |
Summary | Izhodišča. Okužba s H. pylori povzroča gastritis, razjedo želodca in dvanajstnika, limfom MALT, dokazan je tudi pomen okužbe za nastanek želodčnega raka. Več kot polovica človeštva in tudi Slovencev je okuženih s to bakterijo. Zdravimo le tiste, ki jim okužba povzroča navedene bolezni, to je približno 20% okuženih. Osnova zdravljenja je kombinacija zaviralcev protonske črpalke z dvema antibiotikoma. Rezistenca bakterije za najpogostejše antibiotike pa nas sili v iskanje novih možnosti zdravljenja. V prispevku so prikazani razlogi za neuspeh zdravljenja in podatki o rezistenci H. pylori za antibiotike v Sloveniji. Zaključki. Navedene so priporočene antimikrobne sheme zdravljenja okužbe z bakterijo H. pylori v Sloveniji in Evropi. Zaradi slabše uspešnosti zdravljenja je uspeh zdravljenja potrebno preveriti, najbolje z neinvazivno metodo dihalnega testa 13C-urea. Izjema od tega pravila so bolniki, ki izpolnjujejo indikacije za kontrolno gastroskopijo. Predstavljene so tudi terapevtske možnosti v primeru neuspeha priporočenih osnovnih shem zdravljenja. | |
Descriptors | HELICOBACTER INFECTIONS HELICOBACTER PYLORI DRUG RESISTANCE, MICROBIAL ANTIBIOTICS |