Culture-guided treatment approach for Helicobacter pylori infection:Review of the literature

• 作 者: Giovanni Cammarota Gianluca Ianiro Stefano Bibbò Teresa Antonella Di Rienzo Luca Masucci Maurizio Sanguinetti Antonio Gasbarrini
• 机 构: Division of Internal Medicine and Gastroenterology,Department of Internal Medicine,A Gemelli Univers
• 出 处: World Journal of Gastroenterology
• 发表日期: 2014年18期
• 关键词: guided challenging susceptibility advice antibiotic Maastricht endoscopy everywh

The progressive loss of efficacy of standard eradication therapies has made the treatment of Helicobacter pylori(H.pylori)more challenging than ever.Endoscopicguided antibiotic susceptibility testing had previously been suggested to guide treatment after failure of second-line therapies.However,its role has expanded over the years,in accordance with the current Maastricht Guidelines.Several authors have dealt with this topic,developing both efficacy trials and cost-effectiveness trials against resistant H.pylori infections as well as infections in nave patients.However,results are not homogeneous enough to provide definite advice,because antibiotic resistance is not the only reason for treatment failure.Moreover,the culture-guided approach is surrounded by many practical issues,such as the availability of both endoscopy units and microbiology laboratories,and the need for a standard of quality that cannot be satisfied everywhere.Finally,pre-treatment susceptibility testing should be partand not the only weapon-of a targeted,personalized strategy to overcome H.pylori infection.

The progressive loss of efficacy of standard eradication therapies has made the treatment of Helicobacter pylori (H.pylori) more challenging than ever. Endoscopicguided antibiotic susceptibility testing had previously suggested to guide treatment after failure of second-line therapies. However, its role has expanded over the years, in accordance with the current Maastricht Guidelines. Authorized authors have dealt with this topic, developing both efficacy trials and cost-effectiveness trials against resistant H.pylori infections as well as infections in nave patients. not homogeneous enough to provide definite advice, because antibiotic resistance is not the only reason for treatment failure. Moreover, the culture-guided approach is surrounded by many practical issues, such as the the availability of both endoscopy units and microbiology laboratories, and the need for a standard of quality that can not be satisfied everywhere .Finally, pre-treatment susceptibility testing should be partand not the only weapon-of a targeted, personalized strategy to overcome H. pylori infection.