[Personalized therapy for Helicobacter pylori on initial treatment: the initial treatment is the decisive battle]

Zhonghua Yi Xue Za Zhi. 2022 Jun 14;102(22):1631-1634. doi: 10.3760/cma.j.cn112137-20220224-00384.
[Article in Chinese]

Abstract

As widespread eradication treatment continues, the rate of (Helicobacter pylori, H. pylori) antibiotic resistance is increasing. Together with host CYP2C19 gene polymorphisms, H. pylori coccoid transformation, patient compliance, irregular treatment regimens or empirical repeated eradication therapy by physician, H. pylori eradication rates have gradually decreased. Personalized treatment is an effective measure to achieve successful eradication of H. pylori in the initial treatment. With the first approval of molecular diagnostic kit for H. pylori clarithromycin resistance in China and the updated definition of refractory H. pylori infection by the American Gastroenterological Association (AGA), the personalized treatment of H. pylori guided by antibiotic resistance genotype detection in initial treatment, that follows the latest international consensus and guidelines, conforms to the national situation and surpasses the international standards, has come to the forefront.

随着大规模根除治疗的推进,导致幽门螺杆菌(H. pylori)耐药率不断升高,加上宿主CYP2C19基因多态性、H. pylori球形变、患者依从性、医生治疗方案不正规或经验式反复根除治疗等因素,H. pylori根除率逐渐下降。个性化治疗是实现H. pylori感染者首诊成功得以根除的有效措施。随着克拉霉素耐药分子诊断试剂盒在我国首次获批与美国胃肠病协会(AGA)有关难治性H. pylori感染定义更新,遵循国际最新共识与指南、符合国情、赶超国际水平的基于耐药基因检测的H. pylori首诊个性化诊疗走向前台。.

MeSH terms

  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Clarithromycin / therapeutic use
  • Cytochrome P-450 CYP2C19 / genetics
  • Cytochrome P-450 CYP2C19 / therapeutic use
  • Drug Therapy, Combination
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori* / genetics
  • Humans
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Amoxicillin
  • Cytochrome P-450 CYP2C19
  • Clarithromycin