Published online Dec 9, 2015. doi: 10.5497/wjp.v4.i4.274
Peer-review started: July 15, 2015
First decision: September 28, 2015
Revised: October 26, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: December 9, 2015
Processing time: 146 Days and 22.8 Hours
Helicobacter pylori (H. pylori) is a very common bacterium that infects about 50% of the world population in urban areas and over 90% of people living in rural and developing countries. Fluoroquinolones, a class of antimicrobials, have been extensively used in eradication regimens for H. pylori. Levofloxacin is the most commonly used, and in second-line regimens, is one of the most effective options. However, an increasing resistance rate of H. pylori to fluoroquinolones is being observed, that will likely affect their effectiveness in the near future. Other novel fluoroquinolone molecules, such as moxifloxacin, sitafloxacin, gatifloxacin and gemifloxacin, have been proposed and showed encouraging results in vitro, although data on their clinical use are still limited. Further studies in large sample trials are needed to confirm their safety and efficacy profile in clinical practice.
Core tip: In the present minireview, we analyzed current evidence about the use of fluoroquinolones in first, second and third-line eradication regimens for Helicobacter pylori (H. pylori). The increasing resistances to levofloxacin are a worrying issue, that confirm the need to use this drug with proper care. We analyzed the current use of fluoroquinolones in first-line and rescue regimens, underlining possible pitfalls and mistakes that could be avoided in clinical practice. Novel molecules have been investigated, that could offer an interesting tool to combat H. pylori.