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©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Nov 15, 2014; 5(4): 392-399
Published online Nov 15, 2014. doi: 10.4291/wjgp.v5.i4.392
Published online Nov 15, 2014. doi: 10.4291/wjgp.v5.i4.392
Treatment of Helicobacter pylori infection: Past, present and future
Vasilios Papastergiou, Stylianos Karatapanis, Department of Internal Medicine, General Hospital of Rhodes, 85100 Rhodes, Greece
Sotirios D Georgopoulos, Department of Gastroenterology, Athens Medical, P. Faliron Hospital, 17562 Athens, Greece
Author contributions: Papastergiou V contributed to conception and design, drafting the article; Georgopoulos SD contributed to drafting the article, revising the article critically for important intellectual content; Karatapanis S contributed to final approval of the version to be published.
Correspondence to: Stylianos Karatapanis, MD, PhD, Department of Internal Medicine, General Hospital of Rhodes, 10 Kalopetras Str, 85100 Rhodes, Greece. stylkar@otenet.gr
Telephone: +30-224-1080456 Fax: +30-224-1066410
Received: February 12, 2014
Revised: April 15, 2014
Accepted: July 17, 2014
Published online: November 15, 2014
Revised: April 15, 2014
Accepted: July 17, 2014
Published online: November 15, 2014
Core Tip
Core tip: Worldwide increase in prevalence of macrolide resistance has accounted for the failure of standard therapies for the treatment of Helicobacter pylori (H. pylori) infection. Bismuth quadruple, concomitant, sequential and hybrid therapies are now recommended as first-line empirical treatments providing improved efficacy in high clarithromycin resistance settings. As quinolone resistance is rapidly increasing, levofloxacin should be preferentially used in second-line/rescue therapies. There is increasing evidence that adjunct probiotic supplementation improves the therapeutic outcome and tolerability. Genotypic characterization of H. pylori susceptibility to therapy may allow for a tailored therapeutic approach in the future.