H. pylori Eradication Therapy.

As a general rule for the treatment of infectious diseases, clinicians should prescribe anti-H. pylori regimens that have a per-protocol eradication rate ≥90%. However, the eradication rate of the standard triple therapy recommended by most guidelines has generally declined to unacceptable levels (i.e., 80% or less) recently. The reasons for this fall in efficacy with time are uncertain but may relate to the increasing incidence of clarithromycin-resistant strains of H. pylori, poor compliance, and rapid metabolism of proton pump inhibitor (PPI) [1, 2]. Recently, several treatment regimens have emerged to cure H. pylori infection. The novel first-line anti-H. pylori therapies include sequential therapy [3], concomitant quadruple therapy [4], hybrid (dual-concomitant) therapy [5], and bismuth-containing quadruple therapy.