Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2016; 4(1): 5-19
Published online Jan 16, 2016. doi: 10.12998/wjcc.v4.i1.5
Treatment of Helicobacter pylori infection: Current and future insights
Maliheh Safavi, Reyhaneh Sabourian, Alireza Foroumadi
Maliheh Safavi, Department of Biotechnology, Iranian Research Organization for Science and Technology, Tehran 13353-5111, Iran
Reyhaneh Sabourian, Department of Drug and Food Control, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 14598-5114, Iran
Alireza Foroumadi, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 14155-6451, Iran
Author contributions: Safavi M and Sabourian R contributed to write the manuscript; Foroumadi A contributed to design and editing the manuscript.
Conflict-of-interest statement: The authors state no conflict of interest and have received no payment in preparation of this manuscript. This paper has been written upon an invitation of the journal editor to the corresponding author.
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: Alireza Foroumadi, Professor of Medicinal Chemistry, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Enghelab Street, Tehran 14155-6451, Iran. aforoumadi@yahoo.com
Telephone: +98-21-66954708 Fax: +98-21-66461178
Received: April 29, 2015
Peer-review started: April 30, 2015
First decision: July 10, 2015
Revised: October 3, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: January 16, 2016
Abstract

Helicobacter pylori (H. pylori) is an important major cause of peptic ulcer disease and gastric malignancies such as mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma worldwide. H. pylori treatment still remains a challenge, since many determinants for successful therapy are involved such as individual primary or secondary antibiotics resistance, mucosal drug concentration, patient compliance, side-effect profile and cost. While no new drug has been developed, current therapy still relies on different mixture of known antibiotics and anti-secretory agents. A standard triple therapy consisting of two antibiotics and a proton-pump inhibitor proposed as the first-line regimen. Bismuth-containing quadruple treatment, sequential treatment or a non-bismuth quadruple treatment (concomitant) are also an alternative therapy. Levofloxacin containing triple treatment are recommended as rescue treatment for infection of H. pylori after defeat of first-line therapy. The rapid acquisition of antibiotic resistance reduces the effectiveness of any regimens involving these remedies. Therefore, adding probiotic to the medications, developing anti-H. pylori photodynamic or phytomedicine therapy, and achieving a successful H. pylori vaccine may have the promising to present synergistic or additive consequence against H. pylori, because each of them exert different effects.

Keywords: Helicobacter pylori, Therapeutic regimens, Probiotics, Photodynamic, Phytomedicine

Core tip: This article aimed to provides a review of current therapeutic options and the efficacy of some recent regiments. Also, essential need to new therapeutic agents such as probiotics, phytomedicine, photodynamic therapy and protective vaccine are described.