pyloriEradikation

pyloriEradikation refers to medical strategies aimed at eliminating Helicobacter pylori infection from the stomach. Successful eradication reduces gastritis and peptic ulcer recurrence and lowers the risk of gastric cancer in certain populations. It is indicated for patients with active peptic ulcer disease, confirmed H. pylori infection before NSAID therapy in high-risk individuals, certain cases of mucosa-associated lymphoid tissue (MALT) lymphoma, and other gastric mucosal disease where eradication is beneficial.

Eradication is usually achieved with a combination of a proton pump inhibitor (PPI) and antibiotics. Common regimens include standard triple therapy (PPI plus two antibiotics, typically amoxicillin and clarithromycin) for 7–14 days, and bismuth-containing quadruple therapy (PPI, bismuth, tetracycline, and metronidazole) for 10–14 days. A non-bismuth quadruple or concomitant therapy (PPI plus three antibiotics such as amoxicillin, clarithromycin, and metronidazole) for 10–14 days is another option. In areas with high antibiotic resistance or for treatment failures, salvage regimens such as fluoroquinolone-based therapies can be used. Regimens are chosen based on local resistance patterns, patient allergy history, and prior antibiotic exposure.

Eradication success is assessed after completion of therapy using a noninvasive test, usually a urea breath test or stool antigen test, performed at least four weeks after therapy and off proton pump inhibitors for an appropriate interval. If eradication fails, a second-line regimen with different antibiotics is attempted.

Safety considerations include common gastrointestinal side effects and the importance of adherence. pyloriEradikation remains a central component of managing H. pylori-related diseases and precision in regimen selection improves cure rates.