Helicobacter pylori Treatment Strategies in Singapore

The management of Helicobacter pylori infection in Singapore remains a clinical challenge. Similar to other regions, there has been an increase in antibiotic resistance rates through the years. Nonetheless, over the past two decades, clarithromycin-based triple therapy has continued to be used as th...

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Bibliographic Details
Published in:Gut and liver 2021-01, Vol.15 (1), p.13
Main Authors: Tiing Leong Ang, Daphne Ang
Format: Article
Language:Korean
Subjects:
Antibiotic resistance
Eradication
Helicobacter pylori
Online Access:Get full text
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Summary:The management of Helicobacter pylori infection in Singapore remains a clinical challenge. Similar to other regions, there has been an increase in antibiotic resistance rates through the years. Nonetheless, over the past two decades, clarithromycin-based triple therapy has continued to be used as the first line treatment option, with an eradication rate exceeding 90%, although the accepted treatment duration must now be lengthened from 1 to 2 weeks to maintain efficacy. Concomitant and sequential therapies did not demonstrate superiority over standard triple therapy. Current empiric second line treatment utilizes either bismuth-based quadruple therapy or levofloxacin-based triple therapy, but outcomes remain less than ideal. Identifying options to further improve treatment success rates is challenging. Strategies being considered include the use of potent acid suppressants, such as vonoprazan, and H. pylori culture and antibiotic susceptibility testing-guided therapy. (Gut Liver 2021;15:13-18)
ISSN:1976-2283