Posted: Thursday, 29 July 2010 2:20 AM

With antibiotic resistance an increasingly common medical issue, professionals need to change the way they treat infections.

Published first online in GUT on 4 June 2010, Helicobacter pylori treatment in the era of increasing antibiotic resistance  looks at the success of traditional H. pylori treatments and offers suggestions for the future.

“With few exceptions, the most commonly recommended triple Helicobacter pylori regimen (proton pump inhibitor (PPI), amoxicillin and clarithromycin) now provides unacceptably low treatment success. A review of worldwide results suggests that successful eradication using a triple regimen is not consistently observed in any population.” Studies have shown that “triple-therapy” treatment used frequently today as the standard therapy demonstrates only a 70 to 80% success rate. This means that up to a quarter of all patients treated for H. pylori are still infected with the bacteria at the end of treatment.

The authors recommend only regimens with success rates of over 90 to 95%. New regimens should only be compared with the most effective local treatment “and ignore consensus statements and society guidelines if they are not consistent with local results.”

Because of the high rate of resistance to traditional treatments, physicians must adapt a strategy that includes testing, treating and retesting, which is highly recommended by society guidelines. Without a successful method of eradication, patients may rebound after treatment, have repeat H. pylori infections and suffer long term.

The Urea Breath Test is a highly recommended method for detecting H pylori both pre- and post-treatment.
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