Eradication Testing

H. pylori resistance is on the rise1

H. pylori eradication therapy fails in 1 out of 4 patients.2,3

  • Antibiotic resistance, poor compliance—or both—are considered the most common causes of H. pylori treatment failure4
    • Antibiotic resistance may be the strongest predictor of treatment failure5
    • Success rates with the PPI/amoxicillin/clarithromycin combination are in the "unacceptable range" (<80%) worldwide, including in the United States6

Confirm the cure: symptom resolution does not always mean success

step 1

Diagnose if H. pylori is the underlying issue1,7

 
Treat

Consider a guideline-recommended therapy for patients who test positive2,7

 
Wait

Wait 4 weeks to allow for any recolonization that may occur7,8

 
confirm

Test again after completing treatment to confirm successful eradication8,9

Confirmation of H. pylori eradication is recommended—generally with a noninvasive test for active infection.8

References
  • Vakil N, Megraud F. Eradication therapy for Helicobacter pylori. Gastroenterology. 2007;133(3):985-1001.
  • Vakil N, Fendrick AM. How to test for Helicobacter pylori in 2005. Cleve Clin J Med. 2005;72(suppl 2):S8-S13.
  • Chu Y-T, Wang Y-H, Wu J-J, Lei H-Y. Invasion and multiplication of Helicobacter pylori in gastric epithelial cells and implications for antibiotic resistance. Infect Immun. 2010;78(10):4157-4165.
  • Graham DY, Lee Y-C, Wu M-S. Rational Helicobacter pylori therapy: evidence-based medicine rather than medicine-based evidence. Clin Gastroenterol Hepatol. 2014;12(2):177-186.
  • Graham DY, Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut. 2010;59(8):1143-1153.
  • Graham DY, Shiotani A. Newer concepts regarding resistance in the treatment of Helicobacter pylori infections. Nat Clin Pract Gastroenterol Hepatol. 2008;5(6):321-331.
  • Talley NJ; American Gastroenterological Association. American Gastroenterological Association medical position statement: evaluation of dyspepsia. Gastroenterology. 2005;129(5):1753-1755.
  • Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of helicobacter pylori infection. Am J Gastroenterol. 2017;112(2):212-238. http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf. Accessed August 21, 2017.
  • Graham-Lomax K, Graham DY. Contemporary Diagnosis and Management of H. pylori-Associated Gastrointestinal Diseases. 3rd ed. Newtown, PA: Handbooks in Health Care Co; 2005.