Current therapies of Helicobacter pylori infection

If Helicobacter pylori colonization is diagnosed and an indication for treatment exists, multidrug therapy should be prescribed. Single antibiotic, as well as acid-suppressive regimens are largely ineffective against H. pylori despite their good in vitro efficacy. With the currently available multidrug regimens, combining acid suppressive drugs, bismuth compounds and antibiotics, eradication rates of more than 90% can be obtained. Guidelines are needed to improve the use of H. pylori eradication therapy in daily clinical practice. Choices, influenced primarily by the presence of antimicrobial resistance, need for simplicity and costs, have to be made between 14-days ranitidine bismuth citrate dual therapy, 7-days bismuth or omeprazole triple therapy, or 4- to 7-days quadruple therapy. In patients in whom earlier therapy failed, 7-days quadruple therapy is preferred.