New guidelines for Helicobacter pylori: applying them to your practice

The most recent European Helicobacter Study Group consensus recommendations are a state-of-the-art evaluation of the literature on Helicobacter pylori. The traditional indications for H. pylori eradication remain the major indications for eradication therapy in 2007. A role for H. pylori infection has been demonstrated in disease states that were not traditionally thought to be related to H. pylori infection, namely iron deficiency anemia unexplained by other causes, and idiopathic thrombocytopenic purpura. Office-based H. pylori tests are no longer recommended by the consensus group because of their poor sensitivity and specificity in clinical practice. The treatment of H. pylori infection has not changed significantly in the last decade, though promising alternatives are being studied. At present the treatment regimen recommended for world-wide use is triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin. Culture and antimicrobial sensitivity testing are recommended in areas where resistance rates to clarithromycin are high.