Papastergiou V, Georgopoulos SD, Karatapanis S. Treatment of Helicobacter pylori infection: Meeting the challenge of antimicrobial resistance. World J Gastroenterol 2014; 20(29): 9898-9911 [PMID: 25110420 DOI: 10.3748/wjg.v20.i29.9898]
Corresponding Author of This Article
Stylianos Karatapanis, MD, PhD, Department of Internal Medicine, General Hospital of Rhodes, 10 Kalopetras Str, 85100 Rhodes, Greece. stylkar@otenet.gr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Topic Highlight
Open-Access Policy of This Article
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World J Gastroenterol. Aug 7, 2014; 20(29): 9898-9911 Published online Aug 7, 2014. doi: 10.3748/wjg.v20.i29.9898
Treatment of Helicobacter pylori infection: Meeting the challenge of antimicrobial resistance
Vasilios Papastergiou, Sotirios D Georgopoulos, Stylianos Karatapanis
Vasilios Papastergiou, Stylianos Karatapanis, Department of Internal Medicine, General Hospital of Rhodes, 85100 Rhodes, Greece
Sotirios D Georgopoulos, Department of Gastroenterology, Athens Medical, P Faliron Hospital, 17562 Athens, Greece
Author contributions: Papastergiou V contributed to conception and design, drafting the article; Georgopoulos SD contributed to drafting the article, revising the article critically for important intellectual content; Karatapanis S approved of the final version to be published.
Correspondence to: Stylianos Karatapanis, MD, PhD, Department of Internal Medicine, General Hospital of Rhodes, 10 Kalopetras Str, 85100 Rhodes, Greece. stylkar@otenet.gr
Telephone: +30-224-1080456 Fax: +30-224-1066410
Received: November 1, 2013 Revised: January 27, 2014 Accepted: March 12, 2014 Published online: August 7, 2014
Core Tip
Core tip: Rising clarithromycin resistance has accounted for a dramatic decline in the efficacy of standard therapies for Helicobacter pylori (H. pylori) infection. Bismuth-quadruple, sequential, non-bismuth quadruple (concomitant), dual-concomitant (hybrid), and levofloxacin-based regimens are now recommended as preferred empirical treatments (> 90% efficacy). However, empiric treatment of H. pylori is likely to become more challenging as even these improved regimens are prone to the effect of antibiotic resistance. Individualized therapy appears as a reasonable future alternative, currently limited by the shortcomings of performing culture. Advances in the genotypic characterization of H. pylori therapeutic susceptibility are likely to revolutionize our approach to tailored treatment.
