Author/Editor		Tepeš, Bojan; Štabuc, Borut
Title		Priporočila Slovenskega združenja za gastroenterologijo in hepatologijo za zdravljenje okužbe z bakterijo Helicobacter pylori
Translated title		Slovenian society for gastroenterology and hepatology guidelines on the management of Helicobacter pylori infection
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 80, št. 9
Publication year		2011
Volume		str. 647-56
Language		slo
Abstract		Infection with Helicobacter pylori (Hp) is the most common infecion in the world. Half of the world population is infected. The prevalence of infection is declining in the developed world and also in Slovenia, because of better sanitation and eradication therapies. The prevalence of infection with Hp in Slovenia is 25.1%. Only 20% of the infected will develop a duodenal or gastric ulcer, ALT lymphoma or cancer in their lifetime. Hp infection is a risk factor for ulcer bleeding in patients on nonsteroidal antiinflammatory drugs and salicylates. Gastoenterologists diagnose the infection with Hp and prescribe therapy. A general practitioner can diagnose the infection by urea breath test or Hp stool test and prescribe therapy in cases of patients with a proven ulcer disease or in patients with first- degree relatives with gastric cancer. The guidelines on the management of Hp infection, published by the Slovenian Society for Gastroenterology and Hepatology (SZGH) in 2010, recommend one week therapy with proton pump inhibitor (PPI) bid, clarithromycin 500 mg bid and amoxiclline 1000 mg bid in patients without prior therapy with clarithromycin. In the case of prior therapy with macrolides, clarithromycin must be changed for metronidazole 400 mg bid. In the case of therapeutic failure second-line therapy should last 10 days. Secondline therapy can be based on Hp culture and bacterial resistance. The other possibility is PPI bid, colloidal bismuth subcitrate 120 mg qid, oxytetracycline 250 mg qid, metronidazole 400 mg qid; sequential therapy: PI bid 10 days, amoxicillin 1000 mg bid for first 5 days, clarithromycin 500 mg bid and metronidazole 400 mg bid for second 5 days; or PPI bid, amoxicilline 1000 mg bid and levofloxacin 500 mg bid. Hp is a group I human carcinogen responsible for 65% of all gastric cancers. (Abstract truncated at 2000 characters)
Descriptors		HELICOBACTER PYLORI HELICOBACTER INFECTIONS GASTRITIS PEPTIC ULCER STOMACH NEOPLASMS LYMPHOMA, MUCOSA-ASSOCIATED LYMPHOID TISSUE GASTROESOPHAGEAL REFLUX ANEMIA GASTROENTEROLOGY PRACTICE GUIDELINES