Treatment of Helicobacter pylori infection: meeting the challenge of antimicrobial resistance.

Abstract:

:Treatment of Helicobacter pylori (H. pylori) infection is paramount for the management of prevalent gastrointestinal disorders including peptic ulcer disease and gastric cancer. Due to the wide increase in prevalence of H. pylori resistance to antibiotics, clarithromycin-based triple therapies are not any more suitable for unconditional empiric use, and should not be recommended, unless local resistance to this antibiotic is low (< 20%). Alternative strategies have been proposed to overcome the issue of increasing clarithromycin resistance, and some of them are already implemented in clinical practice. These comprise: (1) adoption of novel, more effective, empirical treatments: bismuth quadruple, sequential, non-bismuth quadruple (concomitant), dual-concomitant (hybrid), and levofloxacin-based regimens, the latter mainly designated as second-line/rescue options; (2) perspectives for a susceptibility-guided (tailored) therapeutic approach based on culture-free molecular testing methods; and (3) adjunct use of probiotics to improve eradication rates. The present article is aimed to provide a comprehensive overview of current and emerging strategies in the treatment of H. pylori infection, focusing on the challenge of antimicrobial resistance.

journal_name

World J Gastroenterol

authors

Papastergiou V,Georgopoulos SD,Karatapanis S

doi

10.3748/wjg.v20.i29.9898

subject

Has Abstract

pub_date

2014-08-07 00:00:00

pages

9898-911

issue

29

eissn

1007-9327

issn

2219-2840

journal_volume

20

pub_type

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