title: Optimal First-Line Treatment forHelicobacter pyloriInfection: Recent Strategies.
abstract: A new treatment strategy is needed, as the efficacy of triple therapy containing clarithromycin-the current standard treatment forHelicobacter pyloriinfection-is declining. Increasing antibiotic resistance ofH. pyloriis the most significant factor contributing to eradication failure. Thus, selecting the most appropriate regimen depending on resistance is optimal, but identifying resistance to specific antibiotics is clinically challenging. In a region suspected to have high clarithromycin resistance, bismuth quadruple therapy and so-called nonbismuth quadruple therapies (sequential, concomitant, and sequential-concomitant hybrid) are some first-line regimen options. However, more research is needed regarding appropriate second-line treatments after first-line treatment failure. Tailored therapy, which is based on antibiotic sensitivity testing, would be optimal but has several limitations for clinical use, and an alternative technique is required. A novel potassium-competitive acid blocker-based eradication regimen could be a valuable eradication option in the near future.
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Ju Yup
authors.identifier: 0000-0003-0021-5354
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Kyung Sik
authors.identifier: 0000-0003-1874-9936
authors.initials: KS
authors.lastname: Park