Tuesday, March 26, 2019

H.Pylori

แนวทางเวชปฏิบัติในการวินิจฉัยและการรักษาผู้ป่วยที่มีการติดเชื้อเฮลิโคแบคเตอร์ ไพโลไร (HELICOBACTER PYLORI) ในประเทศไทย พ.ศ. 2558

http://www.gastrothai.net/source/content-file/191_1.Helicobacter%20Pylori.pdf









Treatment of Helicobacter pylori infection in 2018. - NCBI








ACG Clinical Guideline: Treatment of Helicobacter pylori Infection



Quadruple therapy is the new standard. 
Clarithromycin (500 mg), amoxicillin (1 g), metronidazole (500 mg), and a PPI, all given twice a day, are recommended as first-line therapy. 

An alternative regimen is 
bismuth subsalicylate (2 tablets four times a day), metronidazole (500 mg three or four times a day), tetracycline (500 mg four times a day), and a PPI (twice a day). 
Patients on this regimen will need to be informed about bismuth-related stool darkening. 

Triple therapy with levofloxacin (500 mg once a day), amoxicillin (1 g twice a day), and a PPI (twice a day) is an alternative but not recommended as the best initial option.

With Three Guidelines on H pylori, What Should Clinicians Do Differently?
https://www.medscape.com/viewarticle/901280














until the 1980s medical wisdom said the cause of stomach ulcers was too much acid secretion. Therefore, young doctors learned in medical school to treat ulcers with antacids, milk and a bland diet. Then in 1983 a couple of troublemaking Australians named Robin Warren and Barry Marshall suggested that a bacterium actually caused ulcers.

Of course, this was not believed to be possible because no bacterium could survive in the highly acidic environment of the stomach. Marshall and Warren were widely ridiculed after their article appeared, and heckled at conferences where they presented the idea. However, other scientists became interested and started to investigate the alternative theory.

New evidence accumulated over the next decade and ultimately proved that Marshall and Warren were right. They received the Nobel Prize in Medicine in 2005. Today the bacterium, H. pylori, is believed not only to cause ulcers but also most stomach cancers worldwide.

Does Monsanto’s Roundup cause cancer? The law says yes, the science says maybe 
http://theconversation.com/does-monsantos-roundup-cause-cancer-the-law-says-yes-the-science-says-maybe-113998 









furazolidone-, rifabutin-, and sitafloxacin-based therapies might be considered as alternative regimens to eradicate H. pylori in Indonesia, including regions with high metronidazole and clarithromycin resistance rates. Moreover, sitafloxacin but not garenoxacin should be considered for eradication of levofloxacin-resistant strains.

Alternative eradication regimens for Helicobacter pyloriinfection in Indonesian regions with high metronidazole and levofloxacin resistance
https://www.dovepress.com/alternative-eradication-regimens-for-helicobacter-pylori-infection-in--peer-reviewed-article-IDR






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UPDATE  -  2019.03.26

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