Future of Helicobacter pylori Eradication-New Trials

ABSTRACT

The efficacy of standard 7~14 day triple therapy is decreasing, mainly due to increased primary bacterial resistance to antibiotics. Recent published studies have therefore focused on developing alternative strategies for first-line eradication of Helicobacter pylori. Clear evidence now exists that levofloxacin is a viable option for first-line therapy. In addition, data have emerged that the probiotic Saccharomyces boulardii and Lactobacillus supplementation may be a useful adjunct to antibiotic therapy. Among the novel molecules, benzimidazole-derivatives, polycyclic compounds, pyloricidin, and arylthiazole analogues seem to be the most promising. The sequential and 'concomitant' regimes have also been studied in new settings and may have a role in future algorithms. Other studies promote individualized therapies based on host polymorphisms, age, and other demographic factors and resistance. In the near future, tailored therapy could optimize eradication regimens within the different countries. This article reviews the literature published pertaining to new clinical trials of H. pylori eradication.