Treatment ofHelicobacter pyloriinfection: Current and future insights

Abstract

Helicobacter pylori (H. pylori) is an important major cause of peptic ulcer disease and gastric malignancies such as mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma worldwide. H. pylori treatment still remains a challenge, since many determinants for successful therapy are involved such as individual primary or secondary antibiotics resistance, mucosal drug concentration, patient compliance, side-effect profile and cost. While no new drug has been developed, current therapy still relies on different mixture of known antibiotics and anti-secretory agents. A standard triple therapy consisting of two antibiotics and a proton-pump inhibitor proposed as the first-line regimen. Bismuth-containing quadruple treatment, sequential treatment or a non-bismuth quadruple treatment (concomitant) are also an alternative therapy. Levofloxacin containing triple treatment are recommended as rescue treatment for infection of H. pylori after defeat of first-line therapy. The rapid acquisition of antibiotic resistance reduces the effectiveness of any regimens involving these remedies. Therefore, adding probiotic to the medications, developing anti-H. pylori photodynamic or phytomedicine therapy, and achieving a successful H. pylori vaccine may have the promising to present synergistic or additive consequence against H. pylori, because each of them exert different effects.

Prevalence of <i>Helicobacter pylori vacA</i>, <i>cagA</i>, <i>dupA</i> and <i>oipA</i> Genotypes in Patients with Gastric Disease

“…However, the prevalence of the infection varies between developed and developing countries. A higher prevalence of H. pylori infection (75% -83%) was found in Latin American countries than in Japan (40%) and other developed countries [1] [2].…”

The role of nutrition in influencing mechanisms involved in environmentally mediated diseases

“…Additionally, cranberries and their bioactive constituents modulate bacterial adhesion, coaggregation and biofilm formation which may in turn reduce gastrointestinal and urinary tract infections and serve to reduce systemic inflammation (42). Cranberries have also shown efficacy against Helicobacter pylori ( H. pylori ), a Gram-negative bacterium linked to peptic ulcer disease, gastric carcinoma and lymphoid tissue lymphoma (44, 45). …”

Current Status of H. pylori Infection Treatment 2017

“…Amoxicillin is more effective than other drugs due to low resistance rate and high pH environment. Some studies demonstrated that high-dose a PPI plus amoxicillin is overcoming resistance rate and their eradication rate is 72 -81% (Safavi et al, 2016;Vaira et al, 2009). Recently, studies found that it is highly eradicating of H. pylori infection compared to first line therapy; after it cannot achieve in therapeutic efficacy treatment of this infection due to antibiotic bacterial resistance smoking and nonclear dyspepsia (Zullo et al, 2006).…”

“…H. pylori infection is nearly 50-75%affected of the worldwide demography, in the developing countries 70% of people are affected, whereas the percentages little lower, (25-50%) in the developed countries (Safavi et al, 2016;Zhao et al, 2014). It is mainly attained earlier (about previously 10 years) and persist life.…”

“…Most infection, patients are asymptomatic and 10-15% patients infected on the increase chronic inflammation lead to atrophic gastritis, peptic ulcer in addition to gastric adenocarcinoma (Partha et al, 2016).There are different approaches for the eradication of infection caused by H. pylori. One of the widely used methods is several combined antibiotics, such as amoxicillin plus clarithromycin or metronidazole with a proton-pump inhibitor (Safavi et al, 2016). At present, the eradication of H. pylori infection is main troubles antibiotic resistance, patients compliance and intolerance to therapeutic regimens (Niv et al, 2015).…”