%0 Journal Article
%T A new look at anti-Helicobacter pylori therapy
%A Seng-Kee Chuah
%A Feng-Woei Tsay
%A Ping-I Hsu
%A Deng-Chyang Wu
%J World Journal of Gastroenterology
%D 2011
%I Baishideng Publishing Group Co. Limited
%R 10.3748/wjg.v17.i35.3971
%X With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H. pylori) infection. Novel first-line anti-H. pylori therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy. This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects. The best second-line therapy for patients who fail to eradicate H. pylori with first-line therapies containing clarithromycin, amoxicillin and metronidazole is unclear. However, a levofloxacin-based triple therapy is an accepted rescue treatment. Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test. Nonetheless, an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H. pylori infection if antimicrobial sensitivity data are unavailable.
%K Bismuth-containing quadruple therapy
%K Concomitant quadruple therapy
%K Hybrid (dual-concomitant) therapy
%K Rescue anti-Helicobacter pylori treatment
%K Sequential therapy
%U http://www.wjgnet.com/1007-9327/full/v17/i35/3971.htm