Update on triple therapy for eradication of Helicobacter pylori: current status of the art

Riccardo Urgesi,¹ Rossella Cianci,² Maria Elena Riccioni<sup>3

1</sup>Gastroenterology and Endoscopy Unit, Viterbo, ²Institute of Internal Medicine, Catholic University of Rome, ³Digestive Endoscopy Unit, Catholic University of Rome, Rome, Italy

Abstract: With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (ie, 80% or less). Following the failure of conventional triple therapy, novel eradication regimens have been developed including sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy, bismuth-containing quadruple therapy, and a therapy with administration of N-acetylcysteine before a culture-guided antibiotic regimen. This article reviews the literature published on Helicobacter pylori eradication in the last year, focusing on the development of alternative strategies for first-, second-, and third-line rescue therapy for the eradication of H. pylori.

Keywords: sequential therapy, quadruple therapy, concomitant therapy, hybrid therapy, N-acetylcysteine