The bacteria that causes stomach ulcers and raises your risk of gastric cancer is getting harder to kill. A new review of treatment strategies for Helicobacter pylori infection reveals that resistance to clarithromycin, a common antibiotic, now exceeds 15% to 20% in most regions. That means the old standby treatments may not work for many people.
But there is good news. The review found that bismuth quadruple therapy and concomitant regimens still achieve eradication rates above 85%. These are combinations of drugs that attack the bacteria in different ways. Adding probiotics or N-acetylcysteine also improved how well the treatment worked and made it easier to tolerate.
The review covered first-line, salvage, and newer approaches, including vonoprazan, levofloxacin, and rifabutin. It also looked at extra benefits: wiping out H. pylori can lower gastric cancer risk and help with conditions like iron deficiency anemia and idiopathic thrombocytopenic purpura.
Because this is a narrative review, not a controlled trial, the findings summarize existing research rather than proving a new approach. Still, the message is clear: treatment needs to be tailored to local resistance patterns. If you have H. pylori, talk to your doctor about which regimen is best for you.
