Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies

A new treatment strategy is needed, as the efficacy of triple therapy containing clarithromycin—the current standard treatment for Helicobacter pylori infection—is declining. Increasing antibiotic resistance of H. pylori is the most significant factor contributing to eradication failure. Thus, selec...

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Main Authors: Ju Yup Lee, Kyung Sik Park
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2016/9086581
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author Ju Yup Lee
Kyung Sik Park
author_facet Ju Yup Lee
Kyung Sik Park
author_sort Ju Yup Lee
collection DOAJ
description A new treatment strategy is needed, as the efficacy of triple therapy containing clarithromycin—the current standard treatment for Helicobacter pylori infection—is declining. Increasing antibiotic resistance of H. pylori is the most significant factor contributing to eradication failure. Thus, selecting the most appropriate regimen depending on resistance is optimal, but identifying resistance to specific antibiotics is clinically challenging. In a region suspected to have high clarithromycin resistance, bismuth quadruple therapy and so-called nonbismuth quadruple therapies (sequential, concomitant, and sequential-concomitant hybrid) are some first-line regimen options. However, more research is needed regarding appropriate second-line treatments after first-line treatment failure. Tailored therapy, which is based on antibiotic sensitivity testing, would be optimal but has several limitations for clinical use, and an alternative technique is required. A novel potassium-competitive acid blocker-based eradication regimen could be a valuable eradication option in the near future.
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spelling doaj-art-7e784ee8e1db480099715ee26353b8c52025-02-03T01:01:18ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/90865819086581Optimal First-Line Treatment for Helicobacter pylori Infection: Recent StrategiesJu Yup Lee0Kyung Sik Park1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of KoreaA new treatment strategy is needed, as the efficacy of triple therapy containing clarithromycin—the current standard treatment for Helicobacter pylori infection—is declining. Increasing antibiotic resistance of H. pylori is the most significant factor contributing to eradication failure. Thus, selecting the most appropriate regimen depending on resistance is optimal, but identifying resistance to specific antibiotics is clinically challenging. In a region suspected to have high clarithromycin resistance, bismuth quadruple therapy and so-called nonbismuth quadruple therapies (sequential, concomitant, and sequential-concomitant hybrid) are some first-line regimen options. However, more research is needed regarding appropriate second-line treatments after first-line treatment failure. Tailored therapy, which is based on antibiotic sensitivity testing, would be optimal but has several limitations for clinical use, and an alternative technique is required. A novel potassium-competitive acid blocker-based eradication regimen could be a valuable eradication option in the near future.http://dx.doi.org/10.1155/2016/9086581
spellingShingle Ju Yup Lee
Kyung Sik Park
Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies
Gastroenterology Research and Practice
title Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies
title_full Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies
title_fullStr Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies
title_full_unstemmed Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies
title_short Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies
title_sort optimal first line treatment for helicobacter pylori infection recent strategies
url http://dx.doi.org/10.1155/2016/9086581
work_keys_str_mv AT juyuplee optimalfirstlinetreatmentforhelicobacterpyloriinfectionrecentstrategies
AT kyungsikpark optimalfirstlinetreatmentforhelicobacterpyloriinfectionrecentstrategies