Cutrrent Drug Regimens for Helicobacter pylori Treatment

Abstract

Helicobacter pylori is the cause of gastritis and gastric cancer. Treatment with various drug regimens is currently adopted and drug regimens are varied from country to country. Each country has its own clinical practice which largely depends on public health policy and access to medicines. For drug regimens used in Thailand, they still adhere to the Thailand Consensus on Helicobacter pylori Management 2015. The first-line therapy consists of standard triple therapy, sequential therapy, concomitant quadruple therapy, while the second-line therapy includes quadruple therapy and levofloxacin-based triple therapy. In 2018, vonoprazan from Japan was introduced in Thailand. Consequently, vonoprazan is increasingly prescribed as a substitute for proton pump inhibitors in the mainstream regimen, as well as an alternative regimen known as vonoprazan-amoxicillin dual therapy. Therefore, collecting information on all currently available drug regimens is very important in order to find effective drug regimens. However, since most regimens contain at least 2 antibiotics, Helicobacter pylori treatment may cause development of antibiotic resistance and imbalance of bacteria in the gut. The latter situation can also lead to gastrointestinal disease. Drug regimens that should be developed in the future must contain properties of effectively eradicating the infection with shortening course of treatment, and being accessible by all patients. Lastly, the two important things to be aware are the drug-resistant bacteria and the imbalance of bacteria in the gut should not occur.