TY - JOUR
T1 - Culture-guided treatment approach for Helicobacter pylori infection: review of the literature
AU - Cammarota, Giovanni
AU - Ianiro, Gianluca
AU - Masucci, Luca
AU - Sanguinetti, Maurizio
AU - Gasbarrini, Antonio
PY - 2014
Y1 - 2014
N2 - The progressive loss of efficacy of standard eradication therapies has made the treatment of Helicobacter pylori (H. pylori) more challenging than ever. Endoscopic-guided 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 naïve 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 part - and not the only weapon - of a targeted, personalized strategy to overcome H. pylori infection.
AB - The progressive loss of efficacy of standard eradication therapies has made the treatment of Helicobacter pylori (H. pylori) more challenging than ever. Endoscopic-guided 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 naïve 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 part - and not the only weapon - of a targeted, personalized strategy to overcome H. pylori infection.
KW - Antibiotic resistance
KW - Antibiotic susceptibility testing
KW - Culture-guided approach
KW - Helicobacter pylori
KW - Personalized therapy
KW - Antibiotic resistance
KW - Antibiotic susceptibility testing
KW - Culture-guided approach
KW - Helicobacter pylori
KW - Personalized therapy
UR - http://hdl.handle.net/10807/60799
U2 - 10.3748/wjg.v20.i18.5205
DO - 10.3748/wjg.v20.i18.5205
M3 - Article
SN - 2219-2840
VL - 20
SP - 5205
EP - 5211
JO - WORLD JOURNAL OF GASTROENTEROLOGY
JF - WORLD JOURNAL OF GASTROENTEROLOGY
ER -