Personalized Approach in Eradication of Helicobacter pylori Infection

Abstract

The increase in antibiotic resistance to Helicobacter pylori (H. pylori) is associated with a decrease in the effectiveness of eradication therapy. Although some success has been achieved by adjusting therapeutic regimens according to local data on resistance to certain antibiotics, a new approach is needed to ensure a better therapeutic response. Tailored therapy, based on sensitivity tests to antibiotics, is increasingly proving to be a superior therapeutic option, even as a first-line therapy. Moreover, the recently published Maastricht VI guidelines emphasize utilizing a susceptibility-guided strategy in respect to antibiotic stewardship as the first choice for eradication therapy. In addition, polymerase chain reaction (PCR) technology is becoming a standard tool in the diagnosis of H. pylori infections through non-invasive testing, which further optimizes the eradication process. We provide a review regarding the current position of the individualized approach in eradication therapy and its future prospects. Based on novel understandings, the personalized approach is an effective strategy to increase the successful eradication of H. pylori infections.

Helicobacter pylori: A Contemporary Perspective on Pathogenesis, Diagnosis and Treatment Strategies

“…Additionally, it involves a treatment regime specifically tailored to the individual’s needs, according to their family history, genomic makeup, health history, etc. Such an approach is especially useful considering the steadily rising cases of H. pylori resistance against the conventional choice of treatment, i.e., PPI and CAM [ 147 ]. While antibiotic therapy has proven to be significantly successful in the management of the infection, the steadily growing cases of antibiotic resistance and resistance against other agents like proton pump inhibitors highlights the need for the development of alternative therapies and, for now, the careful monitoring of antibiotic administration, weighed on a case-by-case basis.…”

First insight into the whole-genome sequence variations in clarithromycin- resistant Helicobacter pylori clinical isolates in Russia

“…Conventional triple therapy (clarithromycin (CLR), proton pump inhibitor (PPI), metronidazole/amoxicillin) is recommended as rstline treatment in countries with less than 15% clarithromycin resistance, while quadruple therapy (bismuth, PPI, metronidazole/tetracycline/amoxicillin/CLR/tinidazole) -where CLR resistance is over 15% [2][3][4]. According to the newly published Maastricht VI guidelines there are several proposals to improve the effectiveness of the existing eradication therapy regimens: extending the treatment length of triple therapy to 14 days, the usage of a higher dosage of PPI or vonoprazan and the usage of a four-drug regimen supplemented with probiotics [3,5].…”