[Alternatives of drug therapy in Helicobacter pylori infections]

The last three years of research on treatment of Helicobacter pylori infection support the recommendations made by the Working Party, World Congress of Gastroenterology 1990. Meta-analysis shows a noteworthy difference between the recommended regimens favouring the combination of bismuth, metronidazole and tetracycline. No regimen without bismuth has been shown to have a sustained Helicobacter pylori eradication rate exceeding 90%, nor has any alternative regimen been shown convincingly to stem the adverse effects without loss of efficacy. No serious adverse effects have been reported after following the current recommendation of bismuth medication. The highest reported Helicobacter pylori eradication rate according to "intention to treat" approximates 90%, which was obtained using bismuth subnitrate, metronidazole, and oxytetracycline.