Treatment of Helicobacter pylori infection

Helicobacter pylori infection is now recognised as the major cause of chronic active gastritis and peptic ulcer disease and eradication of the infection will prevent recurrence of the majority of such ulcers. A large number of different treatment combinations have been tried, but 100% H pylori eradication has not been achieved due to the use of wrong drug combinations or dosages, non-compliance and development of primary or acquired bacterial resistant strains. However, consistent 95-96% H pylori eradication can now be achieved with triple therapy employing a high-dose proton pump inhibitor twice daily together with any two of the following drugs: nitroimidazole, clarithromycin, or amoxycillin in appropriate dosages taken two to three times daily and all concurrently for one week. The problem of resistant bacterial strains has to be addressed, as this development is one of the consequences of failed eradication treatment.