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ISRN Gastroenterology
Volume 2012 (2012), Article ID 186734, 8 pages
http://dx.doi.org/10.5402/2012/186734
Review Article

Helicobacter pylori Eradication Therapy: Current Availabilities

Unit of Gastroenterology, Digestive Endoscopy, Hepatology and Care of The Child with Liver Transplantation, Department of Pediatrics, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy

Received 23 April 2012; Accepted 19 June 2012

Academic Editors: J.-P. Buts and H. Shimoda

Copyright © 2012 M. Gasparetto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Though Helicobacter pylori (HP) infections have progressively declined throughout most of the industrialized countries, a gradual increase in failure of HP eradication treatments is observed. Aim. To critically review evidence on the efficacy of the therapeutic availabilities for HP eradication, as yet. Methods. A selection of Clinical Trials, Systematic Reviews and Meta-analyses within the time period 2010–2012, was performed through a Medline search. Previous references were included when basically supporting the first selection. Results. An increasing rise in HP resistance rates for antimicrobial agents is currently observed. Further causes of HP treatment failure include polymorphisms of the CYP 2C19, an increased body mass index (BMI), smoking, poor compliance and re-infections. Alternative recent approaches to standard triple therapy have been attempted to increase the eradication rate, including bismuth-containing quadruple therapy, non-bismuth containing quadruple therapy, sequential therapy and levofloxacin-containing regimens. Conclusions. The main current aims should be the maintenance of a high eradication rate (>85%) of HP and the prevention of any increase in antimicrobial resistance. In the next future, the perspective of a tailored therapy could optimize eradication regimens within the different countries.