Antimicrobial management of Helicobacter pylori-associated gastrointestinal tract disease
D. R. Guay and S. J. Gilberstadt
College of Pharmacy, University of Minnesota, Minneapolis, USA.
Since the identification of Helicobacter pylori in 1983, this pathogen has
become the dominant focus of investigation in a variety of gastrointestinal
tract disorders, including peptic ulcer disease, nonulcer dyspepsia, and
gastric carcinoma. During the past 7 years, the efficacy of a variety of
antimicrobial single, dual, and triple therapy regimens--including the use
of acid-suppressive agents, such as proton pump inhibitors, and
histamine2-receptor antagonists--in the eradication of H pylori have been
investigated. Newer treatment approaches, such as dual therapy (proton pump
inhibitor + 1 antimicrobial agent) and 7-day regimens have shown a high
degree of success and have the potential to improve compliance. However,
the optimal regimen, in terms of cost, efficacy, and tolerability, and
optimal length of treatment still remains to be determined.
