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World J Gastroenterol. Aug 14, 2014; 20(30): 10338-10347
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10338
Optimizing clarithromycin-containing therapy for Helicobacter pylori in the era of antibiotic resistance
Javier Molina-Infante, Javier P Gisbert
Javier Molina-Infante, Department of Gastroenterology, Hospital San Pedro de Alcantara, 10003 Caceres, Spain
Javier P Gisbert, Department of Gastroenterology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, 28006 Madrid, Spain
Author contributions: Molina-Infante J and Gisbert JP contributed equally to this work.
Correspondence to: Javier Molina-Infante, MD, Department of Gastroenterology, Hospital San Pedro de Alcantara, C/ Pablo Naranjo s/n, 10003 Caceres, Spain. xavi_molina@hotmail.com
Telephone: +34-927-621543 Fax: +34-927-621543
Received: August 25, 2013
Revised: March 14, 2014
Accepted: April 5, 2014
Published online: August 14, 2014
Core Tip

Core tip: Triple therapy is no longer effective to eradicate Helicobacter pylori infection in most settings across the world. Bismuth quadruple therapy has resurfaced as an ideal replacement, despite its implementation in clinical practice may be troublesome. As such, non-bismuth quadruple therapies remain in the therapeutic front line in clinical practice. This article updates available evidence over the last five years on the efficacy of several non-bismuth quadruple schemes and different tools used to optimize them, providing a novel regionalized therapeutic algorithm, according to novel predicting models based on local antibiotic resistance rates.