HOW TO ACHIEVE A NEAR 100-PERCENT CURE RATE FOR HELICOBACTER-PYLORI INFECTION IN PEPTIC-ULCER PATIENTS - A PERSONAL VIEWPOINT

Infection with Helicobacter pylori is the main etiological factor in d uodenal and gastric ulcer disease, and eradication of the organism cur es peptic ulcer disease. Cure of the infection therefore has become th e ultimate treatment goal in ulcer patients. Only therapies that achie ve a >90% cure rate should be used in clinical practice and, as in any other disease, the therapy with the highest cure rates should be used . Bismuth-based triple therapy is considered the gold standard; it has been used successfully in many studies, usually with good tolerabilit y on the part of patients. Many physicians have been hesitant to presc ribe this therapy. The regimen is complex, and it is thought to have m any side effects. Several groups have shown that concomitant therapy w ith a proton pump inhibitor increases efficacy and lessens side effect s. Moreover, it has become clear that the duration of treatment can be decreased to just 7 days. With this adjustment it now seems sensible to use this short 7-day quadruple therapy, which at present has superi or cure rates when compared with any other anti-Helicobacter therapy. This article is a plea for the use of this regimen and gives practical advice about how to employ therapy in general practice. Suggestions a re made about how to motivate a patient to comply with the therapy pre scribed. If these suggestions are followed, good compliance seems poss ible, and a near 100% cure rate will be within reach.