Management of Helicobacter pylori infection is still a problem in daily routine for many gastroenterologists, internists,
and general practitioners [
1
,
2
]. These problems range from which patients should be tested or which diagnostic tests
should be used, to which antibiotic regimen should be prescribed. The general recommendation
for bacterial infections to always test antibacterial susceptibility may not be applicable
or even efficient in the case of H. pylori management, mainly due to the requirement of an endoscopy [
2
,
3
]. A procedure that is expensive and uncomfortable, and even if performed, culture
and antibiogram are not available in most centers. Moreover, the in vitro testing of the resistances does not accurately correlate with in vivo efficacy of the treatment. In this context, most of the real clinical practice is
performed following “empirical” treatments based on literature (prevalence, efficacy,
resistance), more than on the individual case. The correct use of the empirical approach
for the treatment of H. pylori has two fundamental requisites: accurate estimation on the resistance rates of the
target population and, even more importantly, evidence on the efficacy of each treatment
according to resistance or in comparable contexts [
4
,
5
,
6
,
7
].Abbreviations:
H. pylori (Helicobacter pylori), PPI (Proton pump inhibitor)Keywords
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Published online: June 11, 2016
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- Randomized clinical trial comparing ten day concomitant and sequential therapies for Helicobacter pylori eradication in a high clarithromycin resistance areaEuropean Journal of Internal MedicineVol. 32
