Helicobacter pylori eradication therapy: indications, efficacy and safety.
BACKGROUND
Helicobacter pylori infects up to half of the world's population. It remains the major cause of peptic ulcer disease and is recognised as a carcinogen for its role in gastric carcinogenesis. Successful eradication of the bacteria is associated with improved health outcomes including fewer dyspeptic symptoms, reduced peptic ulcer recurrence and rebleeding, reduced peptic ulcer risk with NSAIDs and as a cure for low-grade gastric MALT lymphoma. The risk of gastric cancer is reduced in those without premalignant mucosal abnormalities at the time of eradication.


OBJECTIVE
This review outlines the current indications and options for therapy of H. pylori with particular reference to drug-induced adverse events associated with treatment.


METHODS
The indications for H. pylori eradication are evidence-based and in accordance with recent consensus statements and recommendations. The eradication treatment is based on numerous clinical trials and meta-analyses.


CONCLUSIONS
Eradication therapy, in general, is safe and well tolerated. Antibiotic therapy may be associated with significant drug adverse reactions, especially gastrointestinal symptoms.
Kwok
Avelyn
A
Concord Hospital, Department of Gastroenterology and Hepatology, Ambulatory Care Endoscopy Unit, Level 1 West, Hospital Road, Concord NSW 2139, Sydney, Australia. rupertleong@hotmail.com
Lam
Thao
T
Katelaris
Peter
P
Leong
Rupert Wl
RW
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000382:microbiology; D009593:Nitroimidazoles / Q000009:adverse effects / Q000627:therapeutic use; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000382:microbiology / Q000517:prevention & control; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D009593:Nitroimidazoles; D054328:Proton Pump Inhibitors