Abstract:
:The progressive loss of efficacy of standard eradication therapies has made the treatment of Helicobacter pylori (H. pylori) more challenging than ever. Endoscopic-guided antibiotic susceptibility testing had previously been suggested to guide treatment after failure of second-line therapies. However, its role has expanded over the years, in accordance with the current Maastricht Guidelines. Several authors have dealt with this topic, developing both efficacy trials and cost-effectiveness trials against resistant H. pylori infections as well as infections in naïve patients. However, results are not homogeneous enough to provide definite advice, because antibiotic resistance is not the only reason for treatment failure. Moreover, the culture-guided approach is surrounded by many practical issues, such as the availability of both endoscopy units and microbiology laboratories, and the need for a standard of quality that cannot be satisfied everywhere. Finally, pre-treatment susceptibility testing should be part - and not the only weapon - of a targeted, personalized strategy to overcome H. pylori infection.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Cammarota G,Ianiro G,Bibbò S,Di Rienzo TA,Masucci L,Sanguinetti M,Gasbarrini Adoi
10.3748/wjg.v20.i18.5205subject
Has Abstractpub_date
2014-05-14 00:00:00pages
5205-11issue
18eissn
1007-9327issn
2219-2840journal_volume
20pub_type
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