title: Management of Helicobacter pylori infections.
abstract: BACKGROUND
  Infection with Helicobacter pylori is associated with severe digestive diseases including chronic gastritis, peptic ulcer disease, and gastric cancer. Successful eradication of this common gastric pathogen in individual patients is known to prevent the occurrence of peptic ulcer disease and gastric cancer.
  
  
  CONCLUSIONS
  With half of the world's population being infected with H, pylori and only few antibiotics result in an effective eradication, a successful antibiotic driven worldwide eradication program seems unlikely. In addition, H. pylori eradication is not always beneficial as it has been described that eradication can be associated with an increased frequency of other disorders such as pediatric asthma, inflammatory bowel diseases and Barrett's Esophagus. We have to accept that eradication of this infection is a two-edged sword that is both useful and harmful and we should therefore focus our H. pylori eradication policy toward selectively identify and destroy only the virulent strains.
  
  
  CONCLUSIONS
  In order to still be able to effectively treat H. pylori infections in the future we need an alternative diagnostic/treatment algorithm. This would involve a shift towards more precise and enhanced disease predicting diagnosis that tries to identify patients with chance of developing severe diseases such as gastric cancer, rather than the current regime that is geared towards find and destroy all H. pylori.
authors: Medical Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors: Amin Talebi Bezmin
authors: AT
authors: Abadi
authors: Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands. h.kusters@umcutrecht.nl.
authors: Johannes G
authors: http://orcid.org/0000-0001-7671-0736
authors: JG
authors: Kusters
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004381:Duodenal Ulcer / Q000382:microbiology; D005756:Gastritis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D013274:Stomach Neoplasms / Q000382:microbiology; D013276:Stomach Ulcer / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial resistance; Eradication therapy; Gastric cancer; H. pylori