Treatment of Helicobacter pylori

One of the most important aspects of treatment in relation to Helicobacter pylori is the emergence of resistance to the conventional antibiotics used to treat the infection. Previously, resistance to amoxycillin had not been described; however, several studies during the course of the year have cast doubt on this assumption, Despite concerns about resistance, relatively fe w novel agents, and in particular novel antibiotics, have been assessed in trials over the previous year, The effectiveness of proton pump inhibitor ( PPI)-based triple therapy has now been well established, and remains one of the first-line therapies of choice. Several studies provide evidence that regimens based on ranitidine bismuth citrate suggest this agent is at least as effective as PPI-based therapy, Various attempts have been made to find more convenient regimens with good results for azithromycin-based therapy in particular. Unfortunately, the management of first-line treatment failur e was not specifically addressed in any large-scale, multicentre study duri ng the year, In our review, we have tried to pay particular attention to th e more innovative studies. What is most obvious is the lack of information on the management of the infection in those previously treated unsuccessful ly, We suggest that novel therapies be assessed for this indication in the forthcoming era, Curr Opin Gastroenterol 15 (suppl 1):S35-S41 (C) 1999 Lipp incott Williams & Wilkins.