Clarithromycin in Helicobacter pylori eradication schemes
Clarithromycin is related to the WHO active against Helicobacter pylori drugs (Podgorbunskikh EI, Maiev IV, Isakov VA). According to the "Standards for the diagnosis and treatment of acid and Helicobacter pylori-associated diseases (fourth Moscow Agreement)" clarithromycin may be included in the eradication schemes Helicobacter pylori. Monotherapy Helicobacter pylori clarithromycin is not allowed.
The use of clarithromycin in the eradication schemes is only possible in areas where resistance to it at least 15-20%. In regions with resistance higher than 20% of its use is only suitable after determination of the sensitivity of Helicobacter pylori to clarithromycin bacteriological method or the polymerase chain reaction. The standard recommends that during the first-line therapy of H. pylori following schemes with clarithromycin, the choice of a particular option depends on the availability of individual patient intolerance of certain drugs, as well as the sensitivity of Helicobacter pylori strains to drugs:
Clarithromycin Retard-OBLPervy option. One of the proton pump inhibitors in the standard dose, and amoxicillin (500 mg four times a day or 1000 mg two times a day) in combination with clarithromycin (500 mg, 2 times a day) during 10-14 days.
The second option (quadruple therapy). Drugs used in the first embodiment (one of the standard dose of PPI, amoxicillin in combination with clarithromycin) supplemented with bismuth tripotassium dicitrate 120 mg four times a day or 240 mg 2 times a day lasting 10-14 days.