Treatment and dosing of Helicobacter pylori infection: when pharmacology meets clinic

Abstract

Helicobacter pylori infection is a major cause of diseases located in the upper gastrointestinal tract. Successful eradication of the bacteria may improve H. pylori-related symptomatic complaints in functional dyspepsia, cure peptic ulcer disease and prevent gastric cancer. As vaccines are not available, the search for the optimal drug regimen has dominated the last decade. Today, most countries prefer a 7- to 10-day regimen containing a proton pump inhibitor, clarithromycin and amoxicillin as first-line treatment. An alternative (or second-line) treatment contains a proton pump inhibitor, bismuth, tetracycline and metronidazole. This review also highlights the impact of new drugs, new drug combinations, and their optimal dosing required to maximise clinical outcome.

Keywords::

• antibiotic resistance
• dosing
• Helicobacter pylori
• pharmacokinetics

Disclosure

P Malfertheiner was a consultant and speaker with Altana and Takeda. He also obtained grants and consultancy from AstraZeneca and Altana.