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Gastroenterol Clin North Am. 2015 Sep;44(3):519-35. doi: 10.1016/j.gtc.2015.05.004. Epub 2015 Jun 19.

Practical Aspects in Choosing a Helicobacter pylori Therapy.

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Department of Gastroenterology, Hospital San Pedro de Alcantara, C/Pablo Naranjo s/n, Caceres 10003, Spain. Electronic address:
Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama Prefecture 701-0114, Japan.


Cure rates greater than 90%-95% should be expected with an antimicrobial therapy for Helicobacter pylori infection. Standard triple therapy does not guarantee these efficacy rates in most settings worldwide anymore. The choice of eradication regimen should be dictated by factors that can predict the outcome: (1) H. pylori susceptibility; (2) patients' history of prior antibiotic therapy; and (3) local data, either resistance patterns or clinical success. Currently, the preferred first-line choices are 14-day bismuth quadruple and 14-day non-bismuth quadruple concomitant therapy. Bismuth quadruple (if not used previously), fluoroquinolone-, furazolidone- and rifabutin-containing regimens might be effective rescue treatments.


Bismuth; Concomitant; Eradication; Helicobacter pylori; Quadruple; Resistance; Therapy; Triple

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