Helicobacter pyloriEradication Therapy: Current Availabilities

Abstract

Background. Though Helicobacter pylori (HP) infections have progressively declined throughout most of the industrialized countries, a gradual increase in failure of HP eradication treatments is observed. Aim. To critically review evidence on the efficacy of the therapeutic availabilities for HP eradication, as yet. Methods. A selection of Clinical Trials, Systematic Reviews and Meta-analyses within the time period 2010–2012, was performed through a Medline search. Previous references were included when basically supporting the first selection. Results. An increasing rise in HP resistance rates for antimicrobial agents is currently observed. Further causes of HP treatment failure include polymorphisms of the CYP 2C19, an increased body mass index (BMI), smoking, poor compliance and re-infections. Alternative recent approaches to standard triple therapy have been attempted to increase the eradication rate, including bismuth-containing quadruple therapy, non-bismuth containing quadruple therapy, sequential therapy and levofloxacin-containing regimens. Conclusions. The main current aims should be the maintenance of a high eradication rate (>85%) of HP and the prevention of any increase in antimicrobial resistance. In the next future, the perspective of a tailored therapy could optimize eradication regimens within the different countries.

Clinical Factors Related with Helicobacter Pylori Infection - Is there an Association with Gastric Cancer History in First-Degree Family Members?

“…Beyond the influence on H pylori infection, recent literature emphasize on the contribution of smoking behavior to the increased risk of gastric carcinogenesis from gastric atrophy (Hishida et al, 2010). However, evidence from recent literature suggests that smoking is one of the factors associated with therapy failure in H pylori eradication (Suzuki et al, 2006;Gasparetto et al, 2012). The most possible cause may be attributable to a reduction in antibiotic delivery due to decreased gastric blood flow and decreased in intragastric pH in cases of smoking (Malfertheiner et al, 2012).…”

Antibiotic treatment forHelicobacter pylori: Is the end coming?

“…The causes for this decline may involve patient compliance, bacterial factors, obesity, smoking, reinfection, and genetic polymorphisms in CYP2C19. However, antibiotic resistance may be the primary reason for reduced eradication of H. pylori infection worldwide [20][21][22] . In addition, the eradication rates differ by region, even in the same country.…”

Choosing Optimal Firstline Helicobacter pylori Therapy: a View from a Region with High Rates of Antibiotic Resistance

“…Topoisomerase controls DNA topology in DNA replication and repair and the drug blocks DNA replication by inhibiting bacterial DNA gyrase A subunit and topoisomerase IV activity, thus it has a bactericidal effect [30]. Levofloxacin is usually not used in pediatric patients due to its harmful effect to articular cartilage in young child; however the data regarding fluoroquinolone usage in pediatrics remains contraindicating [31, 32]. …”