title: [What is new in treating Helicobacter pylori infection?].
abstract: Helicobacter pylori (HP) infection is the commonest chronic bacterial infection of man. Most gastroduodenal ulcers are due to HP infection. In addition, HP infection is considered to be the main aetiological factor of gastric carcinogenesis. For more than 30 years antibiotic therapy has been very effective in eradicating HP. Both antibiotic resistance and insufficient adherence to treatment threaten the efficacy of eradication therapy. Secondary antimicrobial resistance rates of H. pylori as published by the German National Reference Centre show the drastic increase of antibiotic resistance. If the initial standard triple therapy fails, the secondary resistances rise up to about 62 % for metronidazole, 66 % for clarithromycin and 21 % for quinolones. Therefore we should aim at a highly effective first-line treatment strategy that takes into account any risk of antibiotic resistance in an individual patient. Adherence to therapy and eradication efficacy will have to be monitored even more carefully in the future.
authors.affiliation: Klinik für Gastroenterologie, Gastrointestinale Onkologie und Infektiologie, Vivantes Klinikum Am Urban, Berlin.
authors.forename: Hans
authors.initials: H
authors.lastname: Scherübl
authors.affiliation: Medizinische Klinik II, Gastroenterologie und Onkologie, Klinikum Aschaffenburg.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Fischbach
authors.affiliation: Nationales Referenzzentrum für Helicobacter pylori, Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinkum Freiburg.
authors.forename: Erik
authors.initials: E
authors.lastname: Glocker
authors.affiliation: Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg A. ö. R.
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000188:drug therapy; D015363:Quinolones / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones; D008795:Metronidazole; D017291:Clarithromycin