Practical Aspects in Choosing a Helicobacter pylori Therapy

Gastroenterol Clin North Am. 2015 Sep;44(3):519-35. doi: 10.1016/j.gtc.2015.05.004. Epub 2015 Jun 19.

Abstract

Cure rates greater than 90%-95% should be expected with an antimicrobial therapy for Helicobacter pylori infection. Standard triple therapy does not guarantee these efficacy rates in most settings worldwide anymore. The choice of eradication regimen should be dictated by factors that can predict the outcome: (1) H. pylori susceptibility; (2) patients' history of prior antibiotic therapy; and (3) local data, either resistance patterns or clinical success. Currently, the preferred first-line choices are 14-day bismuth quadruple and 14-day non-bismuth quadruple concomitant therapy. Bismuth quadruple (if not used previously), fluoroquinolone-, furazolidone- and rifabutin-containing regimens might be effective rescue treatments.

Keywords: Bismuth; Concomitant; Eradication; Helicobacter pylori; Quadruple; Resistance; Therapy; Triple.

Publication types

  • Review

MeSH terms

  • Antacids / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Bismuth / therapeutic use*
  • Drug Therapy, Combination
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Probiotics / therapeutic use
  • Proton Pump Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Antacids
  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Bismuth