Recommendations for treatment of h pylori infection (Part 1)

heartburn symptomsA post hoc subgroup analysis suggested that, in a small population of patients, heartburn symptoms will improve after H pylori eradication. The benefit of curing H pylori has been supported in other studies as well. The benefits of the test-and-treat approach are probably derived mainly from treatment of underlying ulcer disease and possibly improving a small proportion of functional dyspepsia patients . The lifetime risk in an H pylori-infected individual to develop ulcers is 5% to 15% . It is important to note that, despite successful treatment of the infection, a substantial proportion of patients (at least 50%) will require ongoing treatment for dyspepsia symptoms. In such cases, three options exist: retest for H pylori infection using a urea breath test (UBT) to ensure the infection has been cured; institute empirical therapy in accordance with the CMT recommendations; or perform endoscopy if clinically indicated, at which time biopsies for H pylori infection should be taken. Looking for most efficient drugs for sale? Then you have got to buy antidepressants celexa at the pharmacy of your dream right now, especially since it’s ready and waiting for you to make this perfectly right choice.

Treatment, as recommended in the CMT , consists of triple therapy with a PPI twice a day, clarithromycin 500 mg twice a day and either amoxicillin 1000 mg twice a day or metronidazole 500 mg twice a day. Recently, it has been recommended that PPI-clarithromycin-amoxicillin be used first-line because that combination is unaffected by resistance to metronidazole. Although there are limited data, the prevalence of metronidazole resistance in Canada is estimated to be approximately 20%. First-line use with a metronidazole-containing regimen is a reasonable alternative for patients with a penicillin allergy.

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