Helicobacter pylori eradication therapy: indications, efficacy and safety

Expert Opin Drug Saf. 2008 May;7(3):271-81. doi: 10.1517/14740338.7.3.271.

Abstract

Background: Helicobacter pylori infects up to half of the world's population. It remains the major cause of peptic ulcer disease and is recognised as a carcinogen for its role in gastric carcinogenesis. Successful eradication of the bacteria is associated with improved health outcomes including fewer dyspeptic symptoms, reduced peptic ulcer recurrence and rebleeding, reduced peptic ulcer risk with NSAIDs and as a cure for low-grade gastric MALT lymphoma. The risk of gastric cancer is reduced in those without premalignant mucosal abnormalities at the time of eradication.

Objective: This review outlines the current indications and options for therapy of H. pylori with particular reference to drug-induced adverse events associated with treatment.

Methods: The indications for H. pylori eradication are evidence-based and in accordance with recent consensus statements and recommendations. The eradication treatment is based on numerous clinical trials and meta-analyses.

Results/conclusion: Eradication therapy, in general, is safe and well tolerated. Antibiotic therapy may be associated with significant drug adverse reactions, especially gastrointestinal symptoms.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / therapeutic use
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Duodenal Ulcer / drug therapy
  • Duodenal Ulcer / microbiology
  • Dyspepsia / drug therapy
  • Dyspepsia / microbiology
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / drug therapy
  • Lymphoma, B-Cell, Marginal Zone / microbiology
  • Nitroimidazoles* / adverse effects
  • Nitroimidazoles* / therapeutic use
  • Proton Pump Inhibitors* / adverse effects
  • Proton Pump Inhibitors* / therapeutic use
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / prevention & control
  • Stomach Ulcer / drug therapy
  • Stomach Ulcer / microbiology

Substances

  • Anti-Bacterial Agents
  • Nitroimidazoles
  • Proton Pump Inhibitors