[Treatment of Helicobacter pylori infection: current status]

Considering the etiopathogenic relationship of the stomach infection by Helicobacter pylori with some gastrointestinal disease like peptic ulcer, chronic active gastritis and probably gastric cancer, it is worthwhile to consider treatment of this infection at least in some special cases; peptic ulcer (specially duodenal ulcer) with frequent recurrences, and chronic active gastritis with severe dysplasia. It has been demonstrated worldwide that there is an enormous amount of infected patients. For this reason, the development of an oral vaccine probably potentiated with helper elements such as the choleric toxin, would be ideal. Meanwhile, different therapeutic approaches, most of which are analyzed in this paper are available. At present the pharmacologic agents having demonstrated more effectively are bismuth and clarithromycin, whose action may be potentiated by the use of the proton pump inhibitors, mainly omeprazole. Satisfactory results have been reported by the use of these three agents combined for one week. Previous schemes using triple and quadruple therapy for 14 years have given similar results. Therefore, it seems that the 7-day treatment schemes are going to be recommended for a while. As long as the bacteria is eradicated, there is a possibility of recurrence. A wide range of percentages of recurrence in different countries has been reported. In general, industrialized countries the percentages does not exceed 20%. In Perú, the percentage of recurrence is as high as 73%. In these cases, we suggest the use of periodic treatment (twice a year) should the infection recur.