What are the anti-Helicobacter pylori treatments?

① Bismuth salt. Colloidal bismuth subcitrate (CBS) and bismuth subsalicylate (BSS) are commonly used.

When CBS is used alone, the clearance rate of Hp is 40% ~ 96%, while the eradication rate is only about 20%.

② Amoxicillin. The Hp clearance rate of amoxicillin alone was 60.9% ~ 9 1%, and the eradication rate was 0 ~ 30%.

③ Metronidazole and benzimidazole. In vitro, Hp is moderately sensitive to metronidazole and benzimidazole, and 50% strains are resistant to it. In clinical treatment, the Hp clearance rate of metronidazole alone is only below 50%, and the eradication rate is 0 ~ 10%.

④ Furazolidone. Hp is sensitive to it in vitro, and the clearance rate of furazolidone alone is high, but the eradication rate is only about 65438 0.0%.

⑤ Gentamicin. It is reported that the application of Rebeck (gentamicin sustained-release tablets in stomach).

40mg 1 ~ 2 times a day. After 2 weeks, the Hp clearance rate can reach about 70%.

⑥ Omeprazole. Omeprazole has inhibitory effect on Hp. It is reported that the clearance rate of Hp is 30% ~ 50% abroad and 80% at home, but the eradication rate is very low.

(2) Combination therapy of two drugs

The combination of CBS or BSS with antibiotics or amoxicillin with another antibiotic can improve the eradication rate and reduce the emergence of drug-resistant strains. But the effect of CBS plus amoxicillin is not ideal.

(3) Combination therapy with three drugs

Because the eradication rate of Hp treated with two drugs is not ideal, and some strains are resistant, some scholars discuss the efficacy of combined treatment with three drugs. Adding nitroimidazole to CBS or BSS and tetracycline or amoxicillin can make the eradication rate of Hp reach 80% ~ 90%, but the adverse reaction is great. The 9 th World Congress of Gastroenterology Task Force recommended a 2-week treatment plan: CBS 120mg, 4 times a day; Metronidazole 400mg, 3 times a day; Amoxicillin 500mg or tetracycline 500mg four times a day.