title: Helicobacter pylori eradication in West Asia: a review.
abstract: The efficacy of first- and second-line Helicobacter pylori (H. pylori) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuth-based quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.
authors.affiliation: Hafez Fakheri, Inflammatory Diseases of the Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, 4816633131 Sari, Iran.
authors.forename: Hafez
authors.initials: H
authors.lastname: Fakheri
authors.affiliation: Hafez Fakheri, Inflammatory Diseases of the Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, 4816633131 Sari, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Bari
authors.affiliation: Hafez Fakheri, Inflammatory Diseases of the Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, 4816633131 Sari, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Aarabi
authors.affiliation: Hafez Fakheri, Inflammatory Diseases of the Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, 4816633131 Sari, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001211:Asia, Western / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D016527:Drug Costs; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000472:pathogenicity; D006801:Humans; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D012008:Recurrence; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Eradication; Helicobacter pylori; Recurrence; Resistance; West Asia