Published online Jun 26, 2015. doi: 10.5662/wjm.v5.i2.101
Peer-review started: March 5, 2015
First decision: April 10, 2015
Revised: April 28, 2015
Accepted: May 16, 2015
Article in press: May 18, 2015
Published online: June 26, 2015
Processing time: 124 Days and 19.8 Hours
Helicobacter pylori is one of the most commonly seen bacterium worldwide. It’s in the etiology of multiple gastrointestinal diseases, ranging from gastritis to gastric carcinoma. The antimicrobial therapies, which are frequently prescribed empirically, are losing their effectivity as a result of the increasing antimicrobial resistance. As the standard triple therapy is now left especially in areas with high-clarithromycin resistance due to decreased eradication rates, quadruple therapies are recommended in most regions of the world. Alternatively, concomitant, sequential and hybrid therapies are used. There is still a debate going on about the use of levofloxacin-based therapy in order to prevent the increase in quinolone resistance. If no regimen can achieve the desired eradication rate, culture-guided individualized therapies are highly recommended. Probiotics, statins and n-acetylcysteine are helpful as adjuvant therapies in order to increase the effectiveness of the eradication therapy. Herein, we focused on different eradication regimens in order to highlight the current Helicobacter pylori treatment.
Core tip: In this review, we focused on different treatment regimens used for Helicobacter pylori eradication. The worldwide increase in antibiotic resistance, especially clarithromycin, caused change in the preferred initial treatments. The efficiency of bismuth-quadruple therapy, sequential, concomitant and hybrid therapies are emphasized in relation to each other. In addition, adjuvant therapies to increase the efficiency are reviewed. In conclusion, the optimal approach for eradication was found to be the individualized therapy.