With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment reg...With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment regimens have emerged to cure Helicobacter pylori (H.pylori) infection.Novel first-line anti-H.pylori therapies in 2011 include sequential therapy,concomitant quadruple therapy,hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy.After the failure of standard triple therapy,a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI),bismuth,tetracycline and metronidazole can be employed as rescue treatment.Recently,triple therapy combining a PPI,levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy.This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects.The best second-line therapy for patients who fail to eradicate H.pylori with first-line therapies containing clarithromycin,amoxicillin and metronidazole is unclear.However,a levofloxacin-based triple therapy is an accepted rescue treatment.Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test.Nonetheless,an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H.pylori infection if antimicrobial sensitivity data are unavailable.展开更多
目的:归纳总结抗生素耐药性全球治理的发展历程和每个阶段的特点,并为中国参与抗生素耐药性的全球治理提供启示。方法:采用范围综述的方法在ISI Web of Science、Pubmed、Medline等外文期刊数据库中搜索并筛选有关抗生素耐药性全球治理...目的:归纳总结抗生素耐药性全球治理的发展历程和每个阶段的特点,并为中国参与抗生素耐药性的全球治理提供启示。方法:采用范围综述的方法在ISI Web of Science、Pubmed、Medline等外文期刊数据库中搜索并筛选有关抗生素耐药性全球治理的相关文献,同时收集世界卫生组织、联合国、联合国粮农组织以及世界动物卫生组织等发布的相关资料。结果:抗生素耐药性全球治理的发展历程大致可分为三个阶段:以临床监测为主要策略、由发达国家主导的萌芽阶段;从卫生领域到卫生、农业、环境等多领域共同治理的快速发展阶段;多国家参与并且多领域共同治理的全面覆盖阶段。结论:全世界对于抗生素耐药性全球治理的关注度日益提升,我国应借鉴世界各国采取的有效行动,鼓励多领域协同治理抗生素耐药性问题,以更加积极主动的姿态参与全球治理,并逐步提高社会公众对抗生素耐药性的重视。展开更多
文摘With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment regimens have emerged to cure Helicobacter pylori (H.pylori) infection.Novel first-line anti-H.pylori therapies in 2011 include sequential therapy,concomitant quadruple therapy,hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy.After the failure of standard triple therapy,a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI),bismuth,tetracycline and metronidazole can be employed as rescue treatment.Recently,triple therapy combining a PPI,levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy.This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects.The best second-line therapy for patients who fail to eradicate H.pylori with first-line therapies containing clarithromycin,amoxicillin and metronidazole is unclear.However,a levofloxacin-based triple therapy is an accepted rescue treatment.Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test.Nonetheless,an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H.pylori infection if antimicrobial sensitivity data are unavailable.
文摘目的:归纳总结抗生素耐药性全球治理的发展历程和每个阶段的特点,并为中国参与抗生素耐药性的全球治理提供启示。方法:采用范围综述的方法在ISI Web of Science、Pubmed、Medline等外文期刊数据库中搜索并筛选有关抗生素耐药性全球治理的相关文献,同时收集世界卫生组织、联合国、联合国粮农组织以及世界动物卫生组织等发布的相关资料。结果:抗生素耐药性全球治理的发展历程大致可分为三个阶段:以临床监测为主要策略、由发达国家主导的萌芽阶段;从卫生领域到卫生、农业、环境等多领域共同治理的快速发展阶段;多国家参与并且多领域共同治理的全面覆盖阶段。结论:全世界对于抗生素耐药性全球治理的关注度日益提升,我国应借鉴世界各国采取的有效行动,鼓励多领域协同治理抗生素耐药性问题,以更加积极主动的姿态参与全球治理,并逐步提高社会公众对抗生素耐药性的重视。
