Review – Treatment of Helicobacter pylori infection 2023

Abstract

Helicobacter pylori infection is an infectious disease and should be managed accordingly. Factors that affect patient outcomes, particularly proton inhibitor metabolism, compliance, and antibiotic resistance, are topics of active research. Studies carried out this year aimed to address the above issues by means of comparative studies, meta-analyses, and guidelines. For this year’s review, we have selected studies that are relevant to clinical practice, particularly in the areas of bismuth quadruple therapy (BQT), individualized treatment, high acid suppression therapy, probiotics, barriers to treatment, and factors affecting treatment success. It appears that the globally persistent increasing level of H. pylori antibiotic resistance has led to treatment strategy adaptations, such as prescribing first-line BQT or individualizing first-line treatment based on antimicrobial susceptibility testing. Novel regimens like high-dose dual therapy and vonoprazan-based therapy provide excellent efficacy, while large international studies are still awaited. Compliance should be improved through the awareness of the patient’s concerns and the use of multimedia by the doctor/pharmacist. Future perspectives include making BQT regimens universally available and testing new molecules/regimens.

Keywords

• antibiotic resistance
• compliance
• bismuth-based therapy
• high dose dual therapy
• vonoprazan
• hiv.