Should antibiotic treatment of Helicobacter-positive patients with non-ulcer dyspepsia now be recommended?

Whether cure of Heliobacter pylori infection leads to sustained improvement of non-ulcer dyspepsia (NUD) symptoms is one of the most important unresolved clinical questions in this area. H. pylori has not helped in explaining pathophysiological abnormalities which may cause dyspepsia symptoms. Currently there is insufficient evidence from randomized clinical trials to be sure that cure of H. pylori infection will improve symptoms. There are potential downsides to the widespread use of antibiotics, these include the problem of antibiotic resistance and the possiblity of less adequate pH control with acid-suppressive therapy after the infection has been cured.