Treatment of Helicobacter pylori infection: Current and future insights

Helicobacter pylori(H.pylori) is an important major cause of peptic ulcer disease and gastric malignancies such as mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma worldwide.H.pylori treatment still remains a challenge,since many determinants for successful therapy are involved such as individual primary or secondary antibiotics resistance,mucosal drug concentration,patient compliance,side-effect profile and cost.While no new drug has been developed,current therapy still relies on different mixture of known antibiotics and anti-secretory agents.A standard triple therapy consisting of two antibiotics and a proton-pump inhibitor proposed as the first-line regimen.Bismuthcontaining quadruple treatment,sequential treatment or a non-bismuth quadruple treatment(concomitant) are also an alternative therapy.Levofloxacin containing triple treatment are recommended as rescue treatment for infection of H.pylori after defeat of first-line therapy.The rapid acquisition of antibiotic resistance reduces the effectiveness of any regimens involving these remedies.Therefore,adding probiotic to the medications,developing anti-H.pylori photodynamic or phytomedicine therapy,and achieving a successful H.pylori vaccine may have the promising to present synergistic or additive consequence against H.pylori,because each of them exert different effects.