Treatment of Helicobacter pylori: future therapeutic and prophylactic perspectives

Helicobacter is one of the most widespread, chronic infections in the world and causes a serious disease with a significant mortality. The organism is difficult to eradicate using antibiotic therapy and to date no vaccine is available for use in humans. The most successful treatments comprise acid suppression in combination with two antibiotics and a series of seven day courses will reliably cure around 85% of infected individuals. Further modifications of these regimens via the introduction of newer and more effective antibiotics and acid suppressants may enable the treatment to be simplified, made more effective and cause fewer side effects. However, the major challenge is to develop a specific monotherapy targeted against Helicobacter pylori. The H pylori genome has now been sequenced and this provides an opportunity both to identify specific targets for drug therapy, and to facilitate the identification and production of antigens that may be helpful in manufacturing a vaccine. This paper discusses the future of helicobacter therapy and vaccination.