ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.

Autor:	Chey WD; Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA., Howden CW; University of Tennessee College of Medicine, Memphis, Tennessee, USA., Moss SF; Division of Gastroenterology, Department of Medicine, Providence VA Medical Center, Rhode Island Hospital & Brown University, Providence, Rhode Island, USA., Morgan DR; Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Greer KB; Louis Stokes Cleveland Veteran Affairs Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA., Grover S; Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Shah SC; Division of Gastroenterology, VA San Diego Healthcare System, Division of Gastroenterology, University of California San Diego, San Diego, California, USA.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2024 Sep 01; Vol. 119 (9), pp. 1730-1753. Date of Electronic Publication: 2024 Sep 04.
DOI:	10.14309/ajg.0000000000002968
Abstrakt:	Abstract: Helicobacter pylori is a prevalent, global infectious disease that causes dyspepsia, peptic ulcer disease, and gastric cancer. The American College of Gastroenterology commissioned this clinical practice guideline (CPG) to inform the evidence-based management of patients with H. pylori infection in North America. This CPG used Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology to systematically analyze 11 Population, Intervention, Comparison, and Outcome questions and generate recommendations. Where evidence was insufficient or the topic did not lend itself to GRADE, expert consensus was used to create 6 key concepts. For treatment-naive patients with H. pylori infection, bismuth quadruple therapy (BQT) for 14 days is the preferred regimen when antibiotic susceptibility is unknown. Rifabutin triple therapy or potassium-competitive acid blocker dual therapy for 14 days is a suitable empiric alternative in patients without penicillin allergy. In treatment-experienced patients with persistent H. pylori infection, "optimized" BQT for 14 days is preferred for those who have not been treated with optimized BQT previously and for whom antibiotic susceptibility is unknown. In patients previously treated with optimized BQT, rifabutin triple therapy for 14 days is a suitable empiric alternative. Salvage regimens containing clarithromycin or levofloxacin should only be used if antibiotic susceptibility is confirmed. The CPG also addresses who to test, the need for universal post-treatment test-of-cure, and the current evidence regarding antibiotic susceptibility testing and its role in guiding the choice of initial and salvage treatment. The CPG concludes with a discussion of proposed research priorities to address knowledge gaps and inform future management recommendations in patients with H. pylori infection from North America. (Copyright © 2024 by The American College of Gastroenterology.)
Databáze:	MEDLINE
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