Retreatment of Helicobacter pylori infection after initial treatment failure.
OBJECTIVE
Helicobacter pylori treatment regimens fail to cure the infection in at least 10-20% of patients undergoing initial treatment. Retreatment strategies for patients who have failed initial treatment for H. pylori infection remain poorly described.


METHODS
The literature describing the frequency of H. pylori treatment failure and factors leading to failure is reviewed. The role of antibiotic resistance is discussed and clinical studies assessing success rates according to antibiotic resistance are described. Clinical trials evaluating the treatment success rates for a second episode of treatment are discussed.


RESULTS
The literature describing retreatment of failed H. pylori infection remains limited. The existing data support the use of bismuth-based quadruple therapy or ranitidine bismuth citrate (RBC)-based triple therapy as the preferred agents after initial treatment failure.


CONCLUSIONS
Further studies are needed to better define the optimal second treatment regimen after failed H. pylori treatment.
Kearney
D J
DJ
Gastroenterology Section, University of Washington, VA Puget Sound Health Care System, Seattle, USA.
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000502:physiology; D006801:Humans; D011899:Ranitidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019233:Retreatment; D017211:Treatment Failure
D000897:Anti-Ulcer Agents; C073340:ranitidine bismuth citrate; D011899:Ranitidine; D001729:Bismuth