СОВРЕМЕННЫЕ НАПРАВЛЕНИЯ АНТИХЕЛИКОБАКТЕРНОЙ ТЕРАПИИ
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https://doi.org/10.61699/cjmps-v1-i4-p21-37关键词:
Заболевания желудочно-кишечного тракта, Helicobacter pylori, эрадикации, четырехкомпонентная терапиия, висмутсодержащая квадротерапия摘要
Проведен анализ литературных данных о современных подходах к лечению заболеваний, вызванных Helicobacter pylori (HP), ее клинической эффективности и безопасности. Рассмотрены различные варианты лечения: тройная терапия с применением ингибиторов протонной помпы (ИПП), четырехкомпонентная терапия без применения висмута, а также висмутсодержащая квадротерапия. Указа- но, что терапевтическая эффективность этих методов, а также их роль в снижении устойчивости к антибиотикам при эрадикации HP остаются предметом активной дискуссии. Актуальным представляется создание региональных баз данных по лекарственной устойчивости, поскольку в последние годы во всем мире растет уровень резистентности к кларитромицину, метронидазолу и левофлоксацину, что значительно снижает эффективность традиционной тройной терапии на основе ИПП в качестве терапии первой линии. В заключение отмечено, что наиболее перспективным фундаментальным принципом лечения HP-ассоциированных заболеваний является персонализированная терапия, в основе использования ко- торой — тесты на чувствительность к лекарственным средствам, поскольку установлено, что тройная терапия является высокоэффективной против возбудителя даже в регионах с высокой лекарственной устойчивостью.
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