Management of Helicobacter pylori infection – new insights
Authors: Andrei Gavrilă, Andrada Popescu, Petruț Nuță, Raluca S. Costache, Mariana Jinga, Săndica Bucurică, Bogdan Macadon, Mihăiță Pătrășescu, Florentina Ioniță Radu
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Introduction: Our objective is to review current international guidelines for Helicobacter
Pylori treatment and our department`s experience in this field.
Materials and methods: Helicobacter pylori is a Gram-negative, microaerophilic bacterium that
can be found mainly in the gastric mucus or on the inner surface of the gastric epithelium,
infecting up to 50% of the population. Colonization with this bacterium is not a disease in itself, but
can cause chronic gastritis, peptic ulcer, gastric cancer and MALToma. Because of this, infection
with H. pylori continues to be a major healthcare burden, especially in less-developed countries.
A multitude of non-invasive tests are available for the diagnosis of Helicobacter pylori infection
(blood antibody, stool antigen or urea breath test), but the most reliable method of diagnosis is
histological examination from two sites after endoscopic biopsy, combined with either a microbial
culture or rapid urease test.
Treatment of Helicobacter pylori infection is becoming a challenge, as eradication following
standard triple therapy is decreasing worldwide due to increased bacterial resistance against
antibiotics, which has led to the development of newer therapies such as the sequential treatment
in which a PPI and amoxicillin is given for 5 days followed by a PPI, clarithromycin and
metronidazole for another 5 days, or the quadruple therapy based on a PPI, bismuth subcitrate,
metronidazole and tetracycline for 10 days.
Results and conclusion: H. pylori infection remains one of the most challenging infectious diseases,
causing high morbidity and mortality, mainly because none of the actual antibiotic therapies can
provide successful eradication.