The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Reconciliation of Recent Helicobacter pylori Treatment Guidelines in a Time of Increasing Resistance to Antibiotics
Abstract
Increasing resistance to antibiotics worldwide has adverse effects on the effectiveness of standard therapies to eradicate Helicobacter pylori infection. We reviewed guidelines developed by expert groups in Europe, Canada, and the United States for the treatment of H pylori infection. We compared the recommendations of these guidelines, reconciled them, and addressed the increasing resistance of H pylori to antibiotic therapy regimens. The guidelines recommend bismuth quadruple therapy for first-line treatment, replacing clarithromycin-based triple therapy. There is consensus for concomitant 4-drug therapy as an alternative, especially when bismuth is not available. When therapy is unsuccessful, it is likely due to resistance to clarithromycin, levofloxacin, and/or metronidazole; these drugs, if used previously, should be avoided in subsequent eradication attempts. Second-line therapies should be bismuth quadruple therapy or levofloxacin triple therapy, depending on suspected resistance, reserving rifabutin-based triple and high-dose dual amoxicillin proton pump inhibitor therapy for subsequent treatment attempts. The increasing resistance of H pylori to antibiotic therapy necessitates local availability of susceptibility tests for individuals, and establishment of regional and national monitoring programs to develop evidence-based locally relevant eradication strategies. Further studies into the development of more easily accessible methods of resistance testing, such as biomarker analysis of stool samples, are required. Options under investigation include substituting vonoprazan for proton pump inhibitors, adding probiotics, and vaccine development. Narrow-spectrum antibiotics and new therapeutic targets could be identified based on genomic, proteomic, and metabolomic analyses of H pylori.
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Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
Malfertheiner, P., Megraud, F., O'Morain, C. A., Gisbert, J. P., Kuipers, E. J., Axon, A. T., Bazzoli, F., Gasbarrini, A., Atherton, J., Graham, D. Y., et al. (2017) · Gut · doi:10.1136/gutjnl-2016-312288 · Cited by 2,946
Self-citationKyoto global consensus report on Helicobacter pylori gastritis
Sugano, K., Tack, J., Kuipers, E. J., Graham, D. Y., El-Omar, E. M., Miura, S., Haruma, K., Asaka, M., Uemura, N., & Malfertheiner, P. (2015) · Gut · doi:10.1136/gutjnl-2015-309252 · Cited by 1,876
Self-citationACG Clinical Guideline: Treatment of Helicobacter pylori Infection
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Self-citationAccess to effective antimicrobials: a worldwide challenge
Laxminarayan, R., Matsoso, P., Pant, S., Brower, C., Røttingen, J.-A., Klugman, K., & Davies, S. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00474-2 · Cited by 1,465
Savoldi, A., Carrara, E., Graham, D. Y., Conti, M., & Tacconelli, E. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.07.007 · Cited by 1,270
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Self-citationPlummer, M., Franceschi, S., Vignat, J., Forman, D., & de Martel, C. (2015) · International Journal of Cancer · doi:10.1002/ijc.28999 · Cited by 957
A standardized mouse model of Helicobacter pylori infection: Introducing the Sydney strain
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Cited by
Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report
Malfertheiner, P., Megraud, F., Rokkas, T., Gisbert, J. P., Liou, J.-M., Schulz, C., Gasbarrini, A., Hunt, R. H., Leja, M., O'Morain, C., et al. (2022) · Gut · doi:10.1136/gutjnl-2022-327745 · Cited by 1,533
Self-citationHelicobacter pylori infection and antibiotic resistance — from biology to clinical implications
Tshibangu-Kabamba, E., & Yamaoka, Y. (2021) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-021-00449-x · Cited by 517
Kumar, S., Metz, D. C., Ellenberg, S., Kaplan, D. E., & Goldberg, D. S. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.10.019 · Cited by 286
Zhou, S., Yu, Y., Tian, J., Wang, X., Zeng, M., & Song, H. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1704508 · Cited by 2
Metadata
- Authors
- Fallone, C. A., Moss, S. F., & Malfertheiner, P.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 157
- Issue
- 1
- Pages
- 44-53
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2935703421
- Cited by
- 286
- References
- 47
- FWCI
- 35.65
- Type
- journal article
- Language
- en
- Open access
- closed
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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