Helicobacter pylori: Eradication

The approach to the eradication of Helicobacter pylori infection is evolving rapidly. Initially, it was recommended that eradication therapy be reserved for patients with complicated or rapidly recurring duodenal ulcer disease. More recently, eradication has been recommended for all patients upon the first documented diagnosis of duodenal or gastric ulcer if H. pylori is present. The optimal therapeutic regimen remains to be determined. No single drug has proved effective in eradicating H. pylori. Triple therapy, with its complex regimens, multiple drug requirements, and high incidence of adverse effects, presents barriers to patient compliance that may limit its effectiveness in clinical practice. Combinations of acid-suppressing drugs and antimicrobial agents have the advantage of providing rapid ulcer healing and symptom relief together with the opportunity to cure the infection. This article reviews the reported experience to date from clinical trials of therapy for H. pylori infection.