Guidelines for the salvage therapy: Difference between revisions
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| colspan="1" style="text-align:center; background:LightGreen" |Strong recommendation | | colspan="1" style="text-align:center; background:LightGreen" |Strong recommendation | ||
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| bgcolor="LightGreen" |In patients with persistent H. pylori infection, every effort should be made to avoid antibiotics that have been previously taken by the patient | | bgcolor="LightGreen" |In patients with persistent H. pylori infection, every effort should be made to avoid antibiotics that have been previously taken by the patient. | ||
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1.Bismuth quadruple therapy for 14 days is a recommended salvage regimen. | 1.Bismuth quadruple therapy for 14 days is a recommended salvage regimen. | ||
2. | 2.Levofloxacin triple regimen for 14 days is a recommended salvage regimen. | ||
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| colspan="1" style="text-align:center; background:LemonChiffon" |Conditional recommendation | | colspan="1" style="text-align:center; background:LemonChiffon" |Conditional recommendation | ||
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| bgcolor="LemonChiffon" |Bismuth quadruple therapy or | | bgcolor="LemonChiffon" |Bismuth quadruple therapy or levofloxacin salvage regimens are the preferred treatment options if a patient received a first-line treatment containing | ||
clarithromycin. Selection of best salvage regimen should be directed by local antimicrobial resistance data and the patient’s previous exposure to antibiotics | clarithromycin. Selection of best salvage regimen should be directed by local antimicrobial resistance data and the patient’s previous exposure to antibiotics. | ||
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| bgcolor="LemonChiffon" |Clarithromycin or levofloxacin-containing salvage regimens are the preferred treatment options, if a patient received first-line bismuth quadruple therapy. | | bgcolor="LemonChiffon" |Clarithromycin or levofloxacin-containing salvage regimens are the preferred treatment options, if a patient received first-line bismuth quadruple therapy. | ||
Selection of best salvage regimen should be directed by local antimicrobial resistance data and the patient’s previous exposure to antibiotics | Selection of best salvage regimen should be directed by local antimicrobial resistance data and the patient’s previous exposure to antibiotics. | ||
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| bgcolor="LemonChiffon" |The following regimens can be considered for use as salvage treatment: | | bgcolor="LemonChiffon" |The following regimens can be considered for use as salvage treatment: |
Revision as of 20:07, 1 December 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2], Sargun Singh Walia M.B.B.S.[3]
2017 ACG Guidelines for first-line treatment strategies of peptic ulcer disease for providers in North America
Strong recommendation |
In patients with persistent H. pylori infection, every effort should be made to avoid antibiotics that have been previously taken by the patient. |
The following regimens can be considered for use as salvage treatment:
1.Bismuth quadruple therapy for 14 days is a recommended salvage regimen. 2.Levofloxacin triple regimen for 14 days is a recommended salvage regimen. |
Conditional recommendation |
Bismuth quadruple therapy or levofloxacin salvage regimens are the preferred treatment options if a patient received a first-line treatment containing
clarithromycin. Selection of best salvage regimen should be directed by local antimicrobial resistance data and the patient’s previous exposure to antibiotics. |
Clarithromycin or levofloxacin-containing salvage regimens are the preferred treatment options, if a patient received first-line bismuth quadruple therapy.
Selection of best salvage regimen should be directed by local antimicrobial resistance data and the patient’s previous exposure to antibiotics. |
The following regimens can be considered for use as salvage treatment:
1.Concomitant therapy for 10–14 days is a suggested salvage regimen. 2.Clarithromycin triple therapy should be avoided as a salvage regimen. 3.Rifabutin triple regimen consisting of a PPI, amoxicillin, and rifabutin for 10 days is a suggested salvage regimen. High-dose dual therapy consisting of a PPI and amoxicillin for 14 days is a suggested salvage regimen. |