The recognition of gastritis due to Helicobacter pylori as afactor of major importance has revolutionized the therapeuticapproach to peptic ulcer disease.1,2 The recurrence of ulcerscan be more effectively prevented by a single course of antimicrobialtreatment that eradicates H. pylori infection than by the continuoussuppression of acid secretion. This concept received importantsupport when a recent Consensus Development Conference of theNational Institutes of Health (NIH) recommended that all patientswith ulcers who are also infected with H. pylori receive antimicrobialtherapy.3 Our review will focus on how to diagnose and treatH. pylori infectionin . . . [Full Text of this Article]
The Role of H. pylori in Peptic Ulcer Disease
Diagnosis of Infection
Treatment of Infection
Amoxicillin
Tetracycline
Metronidazole
Clarithromycin
Bismuth
H+/K+ATPase Inhibitors
Therapeutic Regimens to Eradicate H. pylori
Triple Antimicrobial Therapy
Double Antimicrobial Therapy
Double Antimicrobial Therapy plus an Antisecretory Drug
A Single Antimicrobial Drug plus an H+/K+ATPase Antagonist
Single Antimicrobial Therapy
Which Infected Patients Should Be Treated?
Follow-Up of Patients after Eradication of Infection
Recurrence of Infection after Eradication
Summary
Source Information
From the Center for Ulcer Research and Education of the Veterans Affairs/UCLA Gastroenteric Biology Center, West Los Angeles Veterans Affairs Medical Center, and the Department of Medicine, UCLA School of Medicine, Los Angeles (J.H.W.); and the Medical Service, Veterans Affairs Medical Center, and the Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas (W.L.P.). Drs. Walsh and Peterson are members of the Scientific Advisory Board of the Glaxo Institute of Digestive Health.
Address reprint requests to Dr. Walsh at CURE, Bldg. 115, Rm. 115, West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA 90073.
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