Cele na przyszłość

Najważniejsze zadania, którym przyjdzie sprostać w przyszłości, to globalna prewencja raka żołądka. Można ten cel osiągnąć poprzez obejmujące całe populacje diagnostykę i leczenie H. pylori, przeciwdziałanie dramatycznie narastającej antybiotykooporności H. pylori, w tym dogłębne poznanie mechanizmów oporności na leki przeciwdrobnoustrojowe. Kolejny krok to optymalizacja leczenia farmakologicznego poprzez upowszechnienie testów molekularnych oraz zastosowanie nowych antybiotyków, leków przeciwsekrecyjnych czy selektywnych probiotyków. Cele te są ambitne i trudne do realizacji ze względów logistycznych, ekonomicznych i różnic w narodowych systemach zdrowotnych. Świat wciąż oczekuje na skuteczną szczepionkę przeciwko H. pylori.

Abstract

The management of H. pylori infections and the prevention of gastric cancer. A summary of the Maastricht/Florence Consensus Report

Helicobacter pylori is a Gram-negative microaerophilic bacterium with prevalence estimated to be more than half of the world’s population. It is the number one cause of chronic gastritis, gastric and duodenal ulcers as well as gastric adenocarcinoma. H. Pylori gastritis is a separate infectious disease in the new edition of the International Classification of Disease (ICD-11), which requires treatment even if it is asymptomatic. The Maastricht VI / Florence Consensus Report provides an up-to-date guide to the management of H. pylori infections while taking into consideration the prevention of gastric cancer and the mutual relationships between gut microbiota and H. pylori. The most important strategies oriented towards overcoming the increasingly less effective attempts aimed at eradicating the bacteria include molecular testing for H. pylori susceptibility to antibiotics, using bismuth quadruple therapy as a first-line treatment and prolonging eradication regimens to 14 days.

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