التهاب المعدة الضامر الحؤولي البيئي — بكتيريا H. pylori لا تزال إيجابية بعد العلاج الثلاثي بالريفابوتين

References

DOI: 10.14309/ajg.0000000000002968

• The umbrella term "salvage therapy" refers to any treatment provided to patients with persistent H. pylori infection despite initial therapy.
• Of the recommended and suggested salvage regimens, only optimized BQT is suitable for patients with a true penicillin allergy.
• In treatment-experienced patients with persistent H. pylori infection that is confirmed to be clarithromycin-sensitive, PPI- or PCAB-clarithromycin triple therapy is suggested.
• In treatment-experienced patients with persistent H. pylori infection, levofloxacin triple therapy is suggested in patients with known levofloxacin-sensitive H. pylori strains and when optimized bismuth quadruple or rifabutin triple therapies have previously been used or are unavailable (conditional recommendation, low quality of evidence).
• HDDT consists of potent gastric acid suppression therapy (e.g., high-dose PPI or PCAB) and high-dose amoxicillin, preferably for 14 days.
• All patients who are treated for H. pylori infection should undergo a test of cure with an appropriately conducted urea breath test, fecal antigen test, or biopsy-based test at least 4 weeks after completion of therapy.