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Helicobacter pylori: the challenge in therapy

For the therapeutic management of Helicobacter pylori infection, the Maastricht 2–2000 Consensus Report have introduced the concept of the ‘treatment package’ that considers first‐ and second‐line eradication therapies together. According to this consensus statement, the first‐line therapy for H. pylori eradication is a combination of the proton pump inhibitors (PPI) or ranitidine bismuth citrate (RBC) and claritromycin plus either amoxicillin or metronidazole. The second‐line treatment is suggested to be PPI‐quadruple therapy for a minimum of 7 days. If bismuth compounds are not available, PPI‐based triple therapy will have to be used as a second‐line treatment only after susceptibility testing. Since no considerable progress has been made during the past year in treatment regimens, there is still a need for new compounds that are specific for H. pylori, which could constitute future therapies.