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Treatment of Helicobacter pylori infection in the presence of penicillin allergy

查看全文 作　　者：Amit Kumar [1,2]Dutta;Perminder Singh [2]Phull 高影响力作者 机构地区：[1]Department of Gastroenterology,Christian Medical College,Vellore 632004,India;[2]Department of Digestive Disorders,Aberdeen Royal Infirmary,Aberdeen AB252ZN,United Kingdom高影响力机构 出　　处：《World Journal of Gastroenterology》索引2021年第27卷第44期,共8页高影响力期刊 摘　　要：Therapy of Helicobacter pylori(H.pylori)requires a combination of antibiotics together with an acid suppressing agent;most treatment regimens include Amoxicillin as one of the antibiotics,which is an important constituent as resistance to it is low.However,allergies to the penicillin group of antibiotics are not uncommon,and treating H.pylori infection in such individuals can be challenging due to the restricted choice of regimens.The aim of this review is to summarise the evidence for therapeutic options in patients with H.pylori infection and penicillin allergy.A literature search was conducted in PubMed for English language publications using the key words‘Helicobacter’and‘treatment’or‘therapy‘and‘penicillin’or‘beta-lactam’and‘allergy’or‘anaphylaxis’.Eighteen studies were identified that specifically evaluated H.pylori treatment success in penicillin allergic patients.The number of subjects in most of them was low and many were retrospective,uncontrolled,single cohort studies.The most effective option for first-line treatment appears to be Bismuth-based quadruple therapy for 10-14 d.The evidence supports second-line treatment with Levoflaxacin-based triple therapy for 10 d.Patients with persistent H.pylori infection after 2 treatment courses should be considered for testing to confirm penicillin allergy.Further treatment should be guided by the results of H.pylori culture and sensitivity testing. 关 键 词：Helicobacter pylori Infection TREATMENT Penicillin-allergy STOMACH DUODENUM
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