根除幽门螺杆菌,从合理使用抗生素做起

新发传染病电子杂志 ›› 2020, Vol. 5 ›› Issue (1): 38-42.

根除幽门螺杆菌,从合理使用抗生素做起

任小英¹, 李雪宏¹, 张淑贞¹, 王湘雨², Sylvia Young³, Barry Marshall⁴, Alfred Chin Yen Tay⁴

1.深圳市大鹏新区葵涌人民医院检验科,广东深圳 518119;
2.深圳大学第一附属医院,深圳市第二人民医院消化内科,广东深圳 518020;
3.Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA 6009, Australia;
4.University of Western Australia, Marshall Centre, Helicobacter Research Laboratory, Crawley, WA 6009, Australia

出版日期:2020-01-20 发布日期:2020-04-22
通讯作者: Alfred Chin Yen Tay,Email：Alfred.tay@uwa.edu.au
基金资助:
深圳市“医疗卫生三名工程”项目(SZSM201510050)

Eradication of Helicobacter pylori, starting with rational use of antibiotics

Ren Xiaoying¹, Li Xuehong¹, Zhang Shuzhen¹, Wang Xiangyu², Sylvia Young³, Barry Marshall⁴, Alfred Chin Yen Tay⁴

1.Department of Laboratory, Kuiyong people's Hospital, Dapeng New District of Shenzhen, Guangdong Shenzhen 518119, China;
2.Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Guangdong Shenzhen 518020, China;
3.Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, WA 6009, Australia;
4.University of Western Australia, Marshall Centre, Helicobacter Research Laboratory, Crawley, WA 6009, Australia

Online:2020-01-20 Published:2020-04-22

摘要/Abstract

摘要： 幽门螺杆菌根除失败的主要原因是对抗生素产生耐药。由于目前我国对治疗幽门螺杆菌的认识不统一、治疗不规范,随着抗生素的广泛使用,导致幽门螺杆菌对多种抗生素耐药率呈上升趋势,根除率下降。为了提高幽门螺杆菌的根除率,减少抗生素耐药,本文对治疗幽门螺杆菌的七种抗生素的药理机制和幽门螺杆菌对抗生素的耐药机制进行了概述,从而加深临床医生对治疗幽门螺杆菌的抗生素的认识,促使其治疗规范化。同时呼吁临床医生在治疗前进行胃黏膜细菌培养和药敏试验,从而科学规范用药,减少耐药菌株的出现,缩短治疗进程,避免资源浪费,提高幽门螺杆菌的根除率,降低消化性溃疡的复发率,延缓胃黏膜相关淋巴组织（MALT）淋巴瘤的进程,预防胃癌的产生,造福患者。

关键词: 幽门螺杆菌, 抗生素, 耐药

Abstract: Antibiotic resistance is the primary cause of treatment failure on Helicobacter pylori infection. Due to a large number of clinicians involved in the treatment of Helicobacter pylori infection in China, the irregular treatment, and the overuse of antibiotics, the resistance rate of Helicobacter pylori to various antibiotics has gradually increased, leading to the decline of successful treatment of Helicobacter pylori infection. In order to improve the eradication rate of Helicobacter pylori and combat antibiotic resistance, this review summarizes the pharmacological mechanism of seven antibiotics which are currently used for Helicobacter pylori treatment. In addition, this review also evaluates the antibiotic resistance genes associated with each of the recommended drugs to help clinicians gain a deeper understanding of the drug choices. Lastly, in regions where antibiotic resistance is common, we encourage clinical doctors to provide antibiotic susceptibility guided treatment to improve treatment success rate, reduce the emergence of resistant strains, shorten the treatment process, avoid the waste of medical resources, improve the Helicobacter pylori eradication rate, reduce the recurrence of peptic ulcer, delay the process of MALT lymphoma, prevent gastric cancer, and benefit the patients.

Key words: Helicobacter pylori, Antibiotics, Drug resistance

任小英, 李雪宏, 张淑贞, 王湘雨, Sylvia Young, Barry Marshall, Alfred Chin Yen Tay. 根除幽门螺杆菌,从合理使用抗生素做起[J]. 新发传染病电子杂志, 2020, 5(1): 38-42.

Ren Xiaoying, Li Xuehong, Zhang Shuzhen, Wang Xiangyu, Sylvia Young, Barry Marshall, Alfred Chin Yen Tay. Eradication of Helicobacter pylori, starting with rational use of antibiotics[J]. Electronic Journal of Emerging Infectious Diseases, 2020, 5(1): 38-42.

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