PDF(Pubmed)
Abstract：
The eradication rates for Helicobacter pylori globally are decreasing with a dramatic increase in the prevalence of antibiotic resistant bacteria all over the world, including Saudi Arabia. There is no current consensus on the management of H. pylori in Saudi Arabia. The Saudi Gastroenterology Association developed these practice guidelines after reviewing the local and regional studies on the management of H. pylori. The aim was to establish recommendations to guide healthcare providers in managing H. pylori in Saudi Arabia. Experts in the areas of H. pylori management and microbiology were invited to write these guidelines. A literature search was performed, and all authors participated in writing and reviewing the guidelines. In addition, international guidelines and consensus reports were reviewed to bridge the gap in knowledge when local and regional data were unavailable. There is limited local data on treatment of H. pylori. The rate of clarithromycin and metronidazole resistance is high; therefore, standard triple therapy for 10-14 days is no longer recommended in the treatment of H. pylori unless antimicrobial susceptibility testing was performed. Based on the available data, bismuth quadruple therapy for 10-14 days is considered the best first-line and second-line therapy. Culture and antimicrobial susceptibility testing should be considered following two treatment failures. These recommendations are intended to provide the most relevant evidence-based guidelines for the management of H. pylori infection in Saudi Arabia. The working group recommends further studies to explore more therapeutic options to eradicate H. pylori.
摘要：
全球幽门螺杆菌的根除率正在下降，抗生素耐药菌在全世界的流行率急剧上升，包括沙特阿拉伯。目前尚无关于沙特阿拉伯幽门螺杆菌管理的共识。沙特胃肠病学协会在审查了幽门螺杆菌管理的地方和区域研究后制定了这些实践指南。目的是建立建议，以指导医疗保健提供者在沙特阿拉伯管理幽门螺杆菌。幽门螺杆菌管理和微生物学领域的专家被邀请撰写这些指南。进行了文献检索，所有作者都参与了指南的撰写和复习.此外,审查了国际准则和共识报告，以弥补在没有当地和区域数据时的知识差距。关于幽门螺杆菌治疗的本地数据有限。克拉霉素和甲硝唑的耐药率很高；因此，除非进行抗菌药物敏感性试验,否则不再推荐幽门螺杆菌治疗10~14天的标准三联疗法.根据现有数据，铋剂四联疗法10-14天被认为是最佳的一线和二线疗法。在两次治疗失败后，应考虑进行培养和抗菌药物敏感性测试。这些建议旨在为沙特阿拉伯幽门螺杆菌感染的管理提供最相关的循证指南。工作组建议进一步研究以探索更多根除幽门螺杆菌的治疗选择。
