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World J Gastroenterol. Jun 7, 2014; 20(21): 6400-6411
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6400
Efficacy of tailored Helicobacter pylori eradication therapy based on antibiotic susceptibility and CYP2C19 genotype
Mitsushige Sugimoto, Takahisa Furuta
Mitsushige Sugimoto, First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Takahisa Furuta, Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Author contributions: All the authors designed and wrote the paper.
Supported by Grant-in-aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan, No. 22790640 and No. 24590912
Correspondence to: Mitsushige Sugimoto, MD, PhD, First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan. mitsu@hama-med.ac.jp
Telephone: +81-53-4352261  Fax: +81-53-4349447
Received: November 9, 2013
Revised: January 18, 2014
Accepted: February 17, 2014
Published online: June 7, 2014
Core Tip

Core tip: The eradication for Helicobacter pylori infection is mainly influenced by antibiotic susceptibility and insufficient acid inhibition [e.g., cytochrome P450 2C19 (CYP2C19) genotype, proton pump inhibitor (PPI) dose, and PPI treatment schedule]. When a PPI is administered to CYP2C19 rapid metabolizers and intermediate metabolizers, plasma levels of PPIs cannot be maintained between once-daily doses. The intragastric pH attained with four-times-daily-dosing of PPI is significantly higher than those observed when PPI is administered as once-daily-dosing of four-fold doses or twice-daily-dosing of two-fold doses. We describe a tailored treatment that was designed according to pharmacogenomics and antimicrobial susceptibility to achieve an eradication rate exceeding 95%, irrespective of different CYP2C19 genotypes.