Title Liječenje Helicobacter pylori infekcije
Title (english) Treatment of Helicobacter pylori infection
Author Maja Kolar
Mentor Tajana Filipec Kanižaj (mentor)
Committee member Lucija Virović Jukić (predsjednik povjerenstva)
Committee member Jasenka Markeljević (član povjerenstva)
Committee member Tajana Filipec Kanižaj (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Internal Medicine) Zagreb
Defense date and country 2021-07-16, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract Helicobacter pylori je gram-negativna bakterija povezana s mnogim bolestima, uključujući gastritis, peptični ulkus, želučani karcinom i MALT limfom. Više od 4 milijarde ljudi na svijetu zaraženo je Helicobacterom pylori, većinom u zemljama u razviju, dok je prevalencija infekcije u visoko razvijenim zemljama znatno niža. Za dijagnozu infekcije koriste se brojni invazivni i neinvazivni testovi. Strategija „testiraj i tretiraj“ preporučuje se kod mladih pacijenata. Kod pacijenata s alarmantnim simptomima i starijih pacijenata preporučuje se strategija „endoskopiraj i tretiraj“. U smjernicama „Maastricht V“ preporučuje se liječenje Helicobactera pylori standardnom trojnom terapijom IPP-a, amoksicilina i klaritromicina u zemljama gdje je rezistencija Helicobactera pylori na klaritromicin manja od 15%. U zemljama gdje je rezistencija veća od 15%, kao što je Hrvatska i većina europskih zemalja, preporuča se četverostruka terapija bazirana na bizmutu. Problem sve veće rezistencije na antibiotike doveo je do traganja za alternativnim načinima liječenja ove infekcije. Istražuju se korisnost uključivanja probiotika u terapiju i ljekovita svojstva biljaka koje se tradicionalno koriste u liječenju probavnih problema. Velike nade polažu se u razvoj adekvatnog cjepiva koje bi moglo spriječiti infekciju. Cjepivo je najpotrebnije u nisko razvijenim zemljama i zemljama u razvoju gdje je više od 40% djece zaraženo Helicobacterom prije svoje 5. godine. Do sada je jedno cjepivo uspješno prošlo treću fazu kliničkog ispitivanja, no niti jedno još nije odobreno za uporabu.
Abstract (english) Helicobacter pylori is a gram-negative bacteria associated with a number of diseases, including gastritis, peptic ulcer disease, gastric cancer and MALT lymphoma. More than 4 billion people in the world suffer from Helicobacter pylori infection, most of them in developing countries, while the prevalence of the infection is much lower in highly developed countries. The infection is diagnosed by a number of tests, both invasive and non-invasive. The so called “test and treat“ strategy is recommended in young patients. When patients display alarm symptoms and in older patients “endoscope and treat“ is the preferred strategy. “Maastricht V“ guidelines recommend the standard triple therapy of PPI, amoxicillin and clarithromycin for the treatment of Helicobacter pylori infection in countries where clarithromycin resistance is lower than 15%. In countries with high clarithromycin resistance (>15%), like Croatia, and most of European countries, bismuth-containing quadruple therapy is recommended. The growing problem of antibiotic resistance led to a search for an alternative treatment of this infection. The efficacy of adding probiotics in therapy regiments and therapeutic properties of plants traditionally used in treatments of digestive problems is being studied. There are high hopes in the medical community for a development of an adequate vaccine that could prevent the infection. The greatest need for the vaccine is in least developed countries and in developing countries where more than 40% of children are infected with Helicobacter pylori before the age of 5. So far, one vaccine successfully completed the third phase of clinical trial, however no vaccines have yet been approved for use.
Keywords
Helicobacter pylori
liječenje
rezistencija na klaritromicin
trojna terapija
četverostruka terapija
Keywords (english)
Helicobacter pylori
treatment
chlarithromycin resistance
triple therapy
quadruple therapy
Language croatian
URN:NBN urn:nbn:hr:105:741693
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2022-02-24 11:52:35