Helicobacter pylori infection: an overview in 2013, focus on therapy

Objective This article aimed to review the incidence of Helicobacter pylori (H. pylori) infection and its therapy. Data sources Relevant articles published in English were identified by searching in PubMed from 2000 to 2013, with keywords “H. pylori”. Important references from selected articles were also retrieved from Elsevier, Wiley, EBSCO, and SPRINGER. The Chinese articles published were searched from China National Knowledge Infrastructure (CNKI). Study selection Articles about “prevalence”, “gastric carcinoma”, “peptic ulcer”, “gastroesophageal reflux disease”, “functional dyspepsia”, “pathogenic mechanism”, “therapy”, “eradication rate”, “antibiotic resistance”, and “gene polymorphisms” were selected. Results The decreased infection rates of H. pylori could also be linked to the changed disease spectrum, such as the decreased morbidity and recurrence rate of H. pylori-related peptic ulcer, and the increased morbidity of gastroesophageal reflux. Although different treatment regimens have been used for H. pylori infection, the H. pylori eradication rate declined gradually. Due to primary resistance to antibiotics, the gene polymorphism of host and infected strain, and the therapy regimes, H. pylori eradication became even more difficult. Conclusions The prevalence of H. pylori infection had been decreasing, but the rate of eradication failure has dramatically risen in many countries due to resistance to antibiotic. H. pylori therapy in clinical practice is becoming progressively more difficult.