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British Medical Bulletin 54:195-205 (1998)
© 1998 The British Council

research-article

Current regiments for treatment of Helicobacter pylori infection

Adam Harris

The Kent and Sussex Hospital, Royal Tunbridge Wells Kent, UK

Correspondence to: Dr Adam Harris, Consultant Physician and Gastroenterologist, The Kent and Sussex Hospital, Royal Tunbridge Wells, Kent TN4 BAT, UK

Abstract

The aim of treatment of Helicobacter pylori is eradication of the bacterium from the foregut. Treatment is difficult because of the bacterium's habitat and acquired resistance to commonly used antibiotics. Dual theropy, the 2 week combination of omeprazole or ranitidine bismuth citrate and either amoxycillin or clarithromycin, eradicates H. pylori in 50–80% of patients. Classical triple therapy is commonly associated with side effects, is highly dependent on patient's compliance, and is significantly less effective in the presence of metronidazole-resistant strains of H. pylori, where eradication may be 50% One week, twice daily, proton pump inhibitor (PPI)-based triple therapy regimens eradicate about 90% of H. pylori and are associated with mild side effects. Second line regimens include 7 days treatment with omeprazole and 3 times daily amoxycillin and metronidazole or a PPI-based quadruple therapy regimen. In some cases, the bacterium defeats all attempts at eradication.


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