Current Status of the Third-Line Helicobacter pylori Eradication. (2nd May 2018)

• Record Type: Journal Article
• Authors: Choi, Jae Ho; Yang, Young Joo; Bang, Chang Seok; Lee, Jae Jun; Baik, Gwang Ho
• Other Names: Kalayarasan Raja Academic Editor.
• Is Part Of: Gastroenterology research and practice. Volume 2018(2018)
• Publication Date: 2018-05-02
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33005
• DOI: 10.1155/2018/6523653
• Languages: English
• ISSNs: 1687-6121

Abstract

Abstract : Antibiotic resistance is growing worldwide, and patients who have failed consecutive 1st- and 2nd-line H. pylori eradication regimens are increasing. Therefore, the role of the bacterial culture with antibiotic susceptibility testing and molecular susceptibility testing is important for avoiding the use of ineffective antibiotics. However, antibiotic susceptibility testing-guided treatment does not necessarily guarantee successful eradication, and there have been mixed results for the effectiveness of a 3rd-line rescue therapy. Therefore, providing patients with pretreatment medication instructions and education is important. It is also crucial to determine the reason of the eradication failure, including host-related factors (poor compliance to eradication regimen, smoking, and cytochrome P450 2C19 genetic polymorphism) or treatment-related factors (inadequate dosage or duration of therapy and gastric acidity), as such factors can be modified for a tailored therapy. Although the indications for H. pylori eradication have widened, patients at a high risk of gastric cancer can gain definitive benefits with a 3rd-line or even 4th-line therapy.