Monday, May 16, 2016

New Toronto Consensus Guidelines regarding Helicobacter pylori eradication therapy

The new guidelines regarding Helicobacter pylori eradication therapy propose 14-day regimens.

Because of increasing failure of therapy, the consensus group strongly recommended that all H. pylori eradication regimens now be given for 14 days. Recommended first-line strategies include concomitant non-bismuth quadruple therapy (proton pump inhibitor, PPI + amoxicillin + metronidazole + clarithromycin, PAMC), and traditional bismuth quadruple therapy (PPI + bismuth + metronidazole + tetracycline, PBMT). PPI triple therapy (PPI + clarithromycin and either amoxicillin or metronidazole) was restricted to areas with known low clarithromycin resistance or high eradication success with these regimens. Recommended rescue therapies include PBMT and levofloxacin-containing therapy (PPI + amoxicillin + levofloxacin, PAL). Rifabutin regimens should be restricted to patients who fail at least 3 prior options.

SOURCE: American Gastroenterology Association (http://www.gastrojournal.org/article/S0016-5085(16)30108-1/abstract)

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