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pylori infection consists of proton pump inhibitor (PPI) or ranitidine bismuth citrate (RBC) with any two antibiotics of amoxicillin, clarithromycin or metronidazole given for 7–14 days. pylori therapy failure may be higher in clinical practice and it may increase thanks to diffusion of H. The recommended second-line therapy is the quadruple regimen composed by tetracycline, metronidazole, bismuth salts and a PPI.
However, even with the recommended treatment regimens, approximately 20% of patients will fail to obtain H. However, the efficacy of this regimen is limited by poor patient’s compliance due to its side effects, number of tablets per day, and long duration.
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She has already received submissions from others that will comprise her second and subsequent issues.
Several studies have obtained relatively good results with triple therapy combining PPI, rifabutin, and amoxicillin, although a reversible myelotoxicity as leukopenia and thrombocytopenia has been described.
Preliminary good results were also achieved with triples PPI regimens combining levofloxacin and amoxicillin without important adverse effects. pylori eradication, although untoward reactions could limit its use, especially when high doses are employed. pylori treatment failure, non-antimicrobial add-on medications (such as lactoferrin, probiotics and others) could be used with the aim either to improve the eradication rate or to minimize side effects. Karger AG, Basel Published online: May 12, 2006 Issue release date: May 2006 Number of Print Pages: 18 Number of Figures: 6 Number of Tables: 8 ISSN: 0257-2753 (Print) e ISSN: 1421-9875 (Online) For additional information: https:// Copyright: All rights reserved.
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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication.
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However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions.
This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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If a clarithromycin-based regimen was administered in first line, a quadruple regimen or PPI (or RBC) triple therapy with metronidazole and amoxicillin (or tetracycline) should be suggested as a second line.