2014
DOI: 10.3748/wjg.v20.i18.5283
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Treatment ofHelicobacter pyloriinfection: Current status and future concepts

Abstract: Helicobacter pylori (H. pylori) infection is highly associated with the occurrence of gastrointestinal diseases, including gastric inflammation, peptic ulcer, gastric cancer, and gastric mucosa-associated lymphoid-tissue lymphoma. Although alternative therapies, including phytomedicines and probiotics, have been used to improve eradication, current treatment still relies on a combination of antimicrobial agents, such as amoxicillin, clarithromycin, metronidazole, and levofloxacin, and antisecretory agents, suc… Show more

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Cited by 170 publications
(162 citation statements)
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“…2,16 However, the high reported resistance rates of CLA and MTZ significantly reduces the efficacy of these regimens. 5,6,17 To improve the treatment outcome, it is therefore important to use antibiotics, such as AMO, that have low resistance rates to H. pylori .…”
Section: Discussionmentioning
confidence: 99%
“…2,16 However, the high reported resistance rates of CLA and MTZ significantly reduces the efficacy of these regimens. 5,6,17 To improve the treatment outcome, it is therefore important to use antibiotics, such as AMO, that have low resistance rates to H. pylori .…”
Section: Discussionmentioning
confidence: 99%
“…Similarly, the collected data showed an increasing trend of resistance to metronidazole in the recent years in Iran (94%) (9). Eradication rate of triple therapy regimens was found as 97% in metronidazole-susceptible strains, which was much higher than the value for the metronidazoleresistant strains (72.6%) (10). According to the latest guideline for H. pylori medication, the prescribed regimens should be selected based on resistance of H. pylori strains to metronidazole and clarithromycin in each geographic region (11).…”
Section: Introductionmentioning
confidence: 99%
“…4 Treatment with triple therapy (two antibiotics and a proton-pump inhibitor (PPI)) has lost efficacy (now ranging from 71-81%) due to the development of antibiotic resistance in many parts of the world (ranging from 11-63% for clarithromycin, 17-86% for metronidazole, and 14-24% for levofloxacin). [5][6][7][8] To overcome the development of antibiotic resistance, newer strategies using sequential or concomitant quadruple regimes (adding either another antibiotic or bismuth-subcitrate) have resulted in improved H. pylori eradication rates (85-92%). [9][10][11][12] However, some newer quadruple combinations still result in a high frequency of side-effects (23% for sequential therapies and 46% for concomitant therapies).…”
Section: Introductionmentioning
confidence: 99%