Abstract:
:Despite the fact that sequential therapy has been evaluated in more than 2500 patients and has been shown to on average provide Helicobacter pylori eradication in 90% to 94%, some authorities still question whether it should be a first-line anti-H. pylori regimen. Here, we discuss H. pylori eradication using experience and expectations with other common bacterial infections as a frame of reference. H. pylori is no exception and near 100% success is expected for optimized regimens treating susceptible infections. As such, the proper comparator would be the relation to 100% eradication. Superiority to another, often proven inferior, therapy per se provides little or no useful information. Treatment failures in infectious diseases are typically easily explainable and most often relate to the presence of antimicrobial resistance or failure to take the drugs. We provide a model for predicting the results of H. pylori combination therapies in relation to the pattern and prevalence of resistance. The results are consistent with clinical practice and explain why sequential is typically superior and essentially never inferior to triple therapy. We also show when meta-analysis is an inappropriate technique for the analysis of H. pylori clinical trials and discuss how to appropriately use the technique. Finally, we discuss why the location of studies (eg, Italy), is unimportant and explain why, from the standpoint of a therapy for an infectious disease, sequential therapy is a significant advance and should be considered one of the replacements for the outdated legacy triple therapy (proton pump inhibitor--clarithromycin--amoxicillin).
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Graham DY,Rimbara Edoi
10.1097/MCG.0b013e31820ac05esubject
Has Abstractpub_date
2011-04-01 00:00:00pages
309-13issue
4eissn
0192-0790issn
1539-2031pii
00004836-201104000-00003journal_volume
45pub_type
杂志文章abstract::Over the last 2 decades, endoscopic ultrasound (EUS) has evolved from a noninvasive diagnostic tool to a combined diagnostic and therapeutic modality. The use of EUS complementary to endoscopic retrograde cholangiopancreatography (ERCP) has made possible biliary and pancreatic drainage in situations where conventional...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000276
更新日期:2015-03-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200401000-00004
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199012000-00021
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abstract:BACKGROUND:Groove pancreatitis (GP) is a focal form of chronic pancreatitis affecting the paraduodenal groove area, for which consensus on diagnosis and management is lacking. GOALS:We performed a systematic review of the literature to determine patient characteristics and imaging features of GP and to evaluate clinic...
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journal_title:Journal of clinical gastroenterology
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doi:10.1097/00004836-199801000-00020
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更新日期:2017-03-01 00:00:00
abstract:BACKGROUND AND GOAL:Peribiliary cysts, which are known to be associated with various hepatobiliary diseases including alcoholic liver disease, have been reported to originate in the peribiliary glands along the biliary tree. The causal relationship between the peribiliary cysts and alcohol-related hepatic and pancreati...
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pub_type: 杂志文章
doi:10.1097/MCG.0b013e318299c8c1
更新日期:2014-02-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199709000-00013
更新日期:1997-09-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 社论
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:
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pub_type: 杂志文章
doi:10.1097/00004836-199203000-00006
更新日期:1992-03-01 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1097/MCG.0b013e3181ac6489
更新日期:2010-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-197906000-00006
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
doi:10.1097/01.mcg.0000436435.75392.23
更新日期:2014-07-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2011-11-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
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更新日期:2010-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
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journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:
更新日期:1991-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00004836-199904000-00020
更新日期:1999-04-01 00:00:00