blasting h pyloriA study has been released this week that evaluates the optimal eradication strategy for the elimination of infection with the organism, Helicobacter pylori. Most gastroenterologists currently provide the usual ‘Prev-Pak’ for the treatment of H. pylori infections. This therapy generally includes an antibiotic, a PPI, and a bismuth. However, the increasing issues of antibiotic resistance have led clinicians to look to quadruple therapy (the same as above, but with two antibiotics), different or novel antibiotics, or longer courses of therapy.

The study evaluates the value of these different methods mentioned here, in an effort to determine the best therapy for all cases, and the authors have used reasonable statistics to support their theories. However, current data does not support the use of ‘sequential’ therapy as mentioned in this article, but do agree with the concept of longer therapies as also mentioned by the authors.

Unfortunately, there does not seem to be a simple, ‘one size fits all’ approach; but rather, a treatment that depends upon the individual patient and incorporates the local antibiotic resistance patterns.

For more information: Yeo YH et al. First-line Helicobacter pylori eradication therapies in countries with high and low clarithromycin resistance: A systematic review and network meta-analysis. Gut 2016 Sep 26; [e-pub]. (http://dx.doi.org/10.1136/gutjnl-2016-311868)

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