Current Status of the Third-Line Helicobacter pylori Eradication

Antibiotic resistance is growing worldwide, and patients who have failed consecutive 1st- and 2nd-line H. pylori eradication regimens are increasing. Therefore, the role of the bacterial culture with antibiotic susceptibility testing and molecular susceptibility testing is important for avoiding the...

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Main Authors: Jae Ho Choi, Young Joo Yang, Chang Seok Bang, Jae Jun Lee, Gwang Ho Baik
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/6523653
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author Jae Ho Choi
Young Joo Yang
Chang Seok Bang
Jae Jun Lee
Gwang Ho Baik
author_facet Jae Ho Choi
Young Joo Yang
Chang Seok Bang
Jae Jun Lee
Gwang Ho Baik
author_sort Jae Ho Choi
collection DOAJ
description Antibiotic resistance is growing worldwide, and patients who have failed consecutive 1st- and 2nd-line H. pylori eradication regimens are increasing. Therefore, the role of the bacterial culture with antibiotic susceptibility testing and molecular susceptibility testing is important for avoiding the use of ineffective antibiotics. However, antibiotic susceptibility testing-guided treatment does not necessarily guarantee successful eradication, and there have been mixed results for the effectiveness of a 3rd-line rescue therapy. Therefore, providing patients with pretreatment medication instructions and education is important. It is also crucial to determine the reason of the eradication failure, including host-related factors (poor compliance to eradication regimen, smoking, and cytochrome P450 2C19 genetic polymorphism) or treatment-related factors (inadequate dosage or duration of therapy and gastric acidity), as such factors can be modified for a tailored therapy. Although the indications for H. pylori eradication have widened, patients at a high risk of gastric cancer can gain definitive benefits with a 3rd-line or even 4th-line therapy.
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institution OA Journals
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spelling doaj-art-c0bc3f783d2c4be69c9d29a2beb159ea2025-08-20T02:19:22ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/65236536523653Current Status of the Third-Line Helicobacter pylori EradicationJae Ho Choi0Young Joo Yang1Chang Seok Bang2Jae Jun Lee3Gwang Ho Baik4Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of KoreaInstitute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of KoreaInstitute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of KoreaAntibiotic resistance is growing worldwide, and patients who have failed consecutive 1st- and 2nd-line H. pylori eradication regimens are increasing. Therefore, the role of the bacterial culture with antibiotic susceptibility testing and molecular susceptibility testing is important for avoiding the use of ineffective antibiotics. However, antibiotic susceptibility testing-guided treatment does not necessarily guarantee successful eradication, and there have been mixed results for the effectiveness of a 3rd-line rescue therapy. Therefore, providing patients with pretreatment medication instructions and education is important. It is also crucial to determine the reason of the eradication failure, including host-related factors (poor compliance to eradication regimen, smoking, and cytochrome P450 2C19 genetic polymorphism) or treatment-related factors (inadequate dosage or duration of therapy and gastric acidity), as such factors can be modified for a tailored therapy. Although the indications for H. pylori eradication have widened, patients at a high risk of gastric cancer can gain definitive benefits with a 3rd-line or even 4th-line therapy.http://dx.doi.org/10.1155/2018/6523653
spellingShingle Jae Ho Choi
Young Joo Yang
Chang Seok Bang
Jae Jun Lee
Gwang Ho Baik
Current Status of the Third-Line Helicobacter pylori Eradication
Gastroenterology Research and Practice
title Current Status of the Third-Line Helicobacter pylori Eradication
title_full Current Status of the Third-Line Helicobacter pylori Eradication
title_fullStr Current Status of the Third-Line Helicobacter pylori Eradication
title_full_unstemmed Current Status of the Third-Line Helicobacter pylori Eradication
title_short Current Status of the Third-Line Helicobacter pylori Eradication
title_sort current status of the third line helicobacter pylori eradication
url http://dx.doi.org/10.1155/2018/6523653
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