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World J Gastroenterol. Feb 14, 2014; 20(6): 1517-1528
Published online Feb 14, 2014. doi: 10.3748/wjg.v20.i6.1517
Published online Feb 14, 2014. doi: 10.3748/wjg.v20.i6.1517
Second and third line treatment options for Helicobacter pylori eradication
Mingjun Song, Tiing Leong Ang, Department of Gastroenterology, Changi General Hospital, Singapore 529889, Singapore
Author contributions: Song M and Ang TL contributed equally to the manuscript.
Correspondence to: Tiing Leong Ang, MBBS, MRCP (UK), FRCP Edin, Associate Professor, Department of Gastroenterology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore. tiing_leong_ang@cgh.com.sg
Telephone: +65-6-8503558 Fax: +65-6-7816202
Received: September 24, 2013
Revised: October 29, 2013
Accepted: January 6, 2014
Published online: February 14, 2014
Revised: October 29, 2013
Accepted: January 6, 2014
Published online: February 14, 2014
Core Tip
Core tip: The reasons for treatment failure in Helicobacter pylori eradication need not always be due to antibiotic resistance; compliance to therapy and duration should always be evaluated. Choice of therapy need not strictly adhere to guidelines; clinicians should first explore the antibiotic resistance prevalence in their treatment population if possible. Third line therapy generally shows better eradication if it was based on antibiotic susceptibility tests, but this can be time-consuming and more costly. Empirical third-line therapies have yet to show satisfactory eradication rates although most studies generally have smaller study populations.