Journal of Clinical & Experimental Pharmacology

Abstract

Which Treatment in Helicobacter pylori Infection?

Marco Manfredi*,Barbara Bizzarri,Elisabetta Manzali,Alessandro Fugazza,Pierpacifico Gismondi,Gian Luigi de’Angelis

For many years in Helicobacter pylori-positive patients, the most used eradication regimen has been the triple therapy, consisting by the association of two antibiotics usually chosen between amoxicillin, clarithromycin and metronidazole.
In recent years because of the increasingly resistance of this therapy, several options have been used. The most innovative regimen is sequential therapy, but maybe bismuth-containing quadruple therapy is the more frequently used worldwide. Other effective treatments are concomitant therapy or quinolone-containing triple therapy.
Moreover, further approaches have been developed such as the hybrid therapy or the quadruple in which three antibiotics are included in a single capsule.
The therapeutic approach for second-line therapy should be based on the regimen used in the first-line treatment trying to obtain the best eradication rate.
Instead, regarding the third-line therapy, the international guidelines recommend the culture-guided approach or in alternative a therapy based on local antimicrobial resistances.This review attempts to summarize the many possibilities currently available in eradication of Helicobacter pylori infection.