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World J Methodol. Jun 26, 2015; 5(2): 101-107
Published online Jun 26, 2015. doi: 10.5662/wjm.v5.i2.101
Current Helicobacter pylori treatment in 2014
Fatih Ermis, Elif Senocak Tasci
Fatih Ermis, Department of Gastroenterology, Duzce University Faculty of Medicine, 81620 Duzce, Turkey
Elif Senocak Tasci, Department of Internal Medicine, Duzce University Faculty of Medicine, 81620 Duzce, Turkey
Author contributions: Ermis F and Senocak Tasci E contributed equally to this work, generated the tables and figures and wrote the manuscript.
Conflict-of-interest: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fatih Ermis, MD, Associate Professor, Department of Gastroenterology, Duzce University Faculty of Medicine, Beciyorukler Street, Konuralp, 81620 Duzce, Turkey. fatihermis2@hotmail.com
Telephone: +90-53-34689404
Received: March 5, 2015
Peer-review started: March 5, 2015
First decision: April 10, 2015
Revised: April 28, 2015
Accepted: May 16, 2015
Article in press: May 18, 2015
Published online: June 26, 2015
Abstract

Helicobacter pylori is one of the most commonly seen bacterium worldwide. It’s in the etiology of multiple gastrointestinal diseases, ranging from gastritis to gastric carcinoma. The antimicrobial therapies, which are frequently prescribed empirically, are losing their effectivity as a result of the increasing antimicrobial resistance. As the standard triple therapy is now left especially in areas with high-clarithromycin resistance due to decreased eradication rates, quadruple therapies are recommended in most regions of the world. Alternatively, concomitant, sequential and hybrid therapies are used. There is still a debate going on about the use of levofloxacin-based therapy in order to prevent the increase in quinolone resistance. If no regimen can achieve the desired eradication rate, culture-guided individualized therapies are highly recommended. Probiotics, statins and n-acetylcysteine are helpful as adjuvant therapies in order to increase the effectiveness of the eradication therapy. Herein, we focused on different eradication regimens in order to highlight the current Helicobacter pylori treatment.

Keywords: Helicobacter pylori, Eradication, Treatment, Bismuth-quadruple therapy, Sequential therapy, Concomitant therapy, Hybrid therapy

Core tip: In this review, we focused on different treatment regimens used for Helicobacter pylori eradication. The worldwide increase in antibiotic resistance, especially clarithromycin, caused change in the preferred initial treatments. The efficiency of bismuth-quadruple therapy, sequential, concomitant and hybrid therapies are emphasized in relation to each other. In addition, adjuvant therapies to increase the efficiency are reviewed. In conclusion, the optimal approach for eradication was found to be the individualized therapy.