21.8 : 治疗消化性溃疡中的幽门螺杆菌：抗菌疗法

Helicobacter pylori or H. pylori, a gram-negative bacillus, thrives in the stomach's acidic environment, impairing somatostatin production. This increases gastrin and acid secretion and reduces bicarbonate production, causing gastric and duodenal ulcers.

H. pylori infection is detected via endoscopic biopsy or noninvasive methods.

It can be treated via triple or quadruple therapy.

The triple therapy combines antibiotics clarithromycin and metronidazole or amoxicillin with a proton pump inhibitor or PPI.

Quadruple therapy includes antibiotics, a PPI, and bismuth subsalicylate.

Bismuth-containing over-the-counter preparations like bismuth chelate may enhance mucosal protection, inhibiting H. pylori.

Effective treatment regimens typically last 10-14 days.

However, they have drawbacks, including medication-related side effects such as nausea, vomiting, and blackening of the tongue and feces, inconvenient multiple-drug regimens, and antibiotic resistance.