title: Helicobacter pylori: diagnosis and treatment.
abstract: OBJECTIVE
  Multiple diagnostic methods and treatment strategies have been developed to detect and treat the Helicobacter pylori infection. Many of them have stood the test of time; others lost their value with the introduction of new test and treatment modalities. This review focuses on the current diagnostic methods and their clinical implications, as well as on established and novel treatment strategies.
  
  
  RESULTS
  The increasing antimicrobial resistance has resulted in a decline of the success rate of recommended eradication regimens. The current guidelines recommend as first-line treatment clarithromycin, amoxicillin or metronidazole, and proton pump inhibitor twice daily, but recent studies have demonstrated an increasing eradication failure with these regimens. Several treatment modifications have been adopted regarding duration and combination of substances.
  
  
  CONCLUSIONS
  The currently recommended first-line treatments are effective and well tolerated. In areas with high antimicrobial resistance rates, new antibiotic combinations and modifications in the sequence of drug administration are proposed as alternative treatment options to standard triple therapy. Future treatment strategies have to focus on regional antimicrobial resistance adopted treatment selection and the development of new antibiotics.
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Selgrad
authors.forename: Arne
authors.initials: A
authors.lastname: Kandulski
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D001729:Bismuth / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D024841:Fluoroquinolones / Q000008:administration & dosage; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D015242:Ofloxacin / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D017828:Rifabutin / Q000008:administration & dosage; D017211:Treatment Failure
chemical_list: D024841:Fluoroquinolones; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D017828:Rifabutin; D000658:Amoxicillin; D015242:Ofloxacin; D017291:Clarithromycin; D001729:Bismuth