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The Ideal Helicobacter pylori Treatment for the Present and the Future
- Source :
- Digestion. 103:62-68
- Publication Year :
- 2021
- Publisher :
- S. Karger AG, 2021.
-
Abstract
- Background: Helicobacter pylori eradication treatments are widely performed to improve gastric mucosal inflammation, promote ulcer healing, and reduce the incidence of gastric cancer. However, there are several issues associated with H. pylori eradication treatment. First, various treatment regimens are currently used worldwide, and the standard treatment varies with region and country. Second, the antimicrobial resistance of H. pylori is increasing due to indiscriminate antibiotic use. Finally, gut microbiota dysbiosis is potentially induced by H. pylori treatment. Summary: Based on current international guidelines and a network meta-analysis comparing the effects of various treatment regimens, nonbismuth quadruple therapies for 10–14 days and vonoprazan-based triple therapy for 7 days are the currently recommended H. pylori treatment regimens. These regimens show good eradication rates of approximately 90%, even in areas where antimicrobial-resistant strains are highly prevalent. However, these regimens still have inherent drawbacks that may promote further increases in antimicrobial resistance and induce gut microbiota dysbiosis because of the empiric use of multiple antibiotics. Key Message: The ideal concept for the present and future H. pylori eradication treatment involves “a simple, cost-effective strategy that fosters compliance without having a negative impact on the gut microbiota or contributing to future antimicrobial resistance.” One interesting possibility that may fulfill this concept is a dual therapy involving vonoprazan and amoxicillin. This is the simplest treatment regimen that provides acceptable eradication rates, improves safety and tolerability, and minimizes the potential for increasing antimicrobial resistance or causing gut microbiota dysbiosis.
- Subjects :
- medicine.medical_specialty
biology
Vonoprazan
business.industry
medicine.drug_class
Standard treatment
Antibiotics
Gastroenterology
Helicobacter pylori
Gut flora
biology.organism_classification
medicine.disease
Antimicrobial
Antibiotic resistance
medicine
Intensive care medicine
business
Dysbiosis
Subjects
Details
- ISSN :
- 14219867 and 00122823
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- Digestion
- Accession number :
- edsair.doi...........cbfac1d2fbe94e4711f1b447e14af125