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World J Gastroenterol. Jan 7, 2015; 21(1): 139-154
Published online Jan 7, 2015. doi: 10.3748/wjg.v21.i1.139
Pharmacological therapy used in the elimination of Helicobacter pylori infection: A review
Ariolana A dos Santos, Adriana A Carvalho
Ariolana A dos Santos, Adriana A Carvalho, Department of Pharmacy, Federal University of Sergipe, Campus Lagarto, 49400-00 Lagarto, Sergipe, Brazil
Author contributions: dos Santos AA and Carvalho AA contributed equally to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adriana A Carvalho, MD, PhD, Professor of Pharmacy, Department of Pharmacy, Federal University of Sergipe, Campus Lagarto, Rua Padre Alvares Pitangueira, no.248 Centro, 49400-00 Lagarto, Sergipe, Brazil. a.acarvalho@yahoo.com.br
Telephone: +55-91-916944 Fax: +55-91-916944
Received: July 13, 2014
Peer-review started: July 13, 2014
First decision: August 6, 2014
Revised: August 16, 2014
Accepted: September 18, 2014
Article in press: September 19, 2014
Published online: January 7, 2015
Abstract

The optimal therapy for Helicobacter pylori (H. pylori) infection should combine a high cure rate and a short treatment duration with a favorable side-effect profile and should maintain a low cost. Several strategies have been proposed to increase the H. pylori eradication rate, including the extension of the treatment duration to 14 d, the use of a four-drug regimen (quadruple, sequential, and concomitant treatments), and the use of novel antibiotics, such as levofloxacin. However, triple therapy remains the most widely accepted first-line treatment regimen in Brazil and the United States and throughout Europe. Because this therapy is limited by resistance to clarithromycin, other therapeutic regimens have been investigated worldwide. This review describes the current literature involving studies directly comparing these different therapies and their efficacies.

Keywords: Clarithromycin resistant, Helicobacter pylori, Peptic ulcers, Triple therapy, Treatment

Core tip:Helicobacter pylori is a bacterium that is commonly found in the stomach and is capable of causing a number of digestive problems, including ulcers and stomach cancer. Over the past few years, the efficacy of conventional therapy has decreased. However, new therapies are not commonly accepted as first-line treatments in some countries because of a lack of national validation studies. This review aimed to report studies demonstrating the effectiveness of different non-conventional therapies and comparing them with conventional triple therapy.