G. Fiorini et al. / Open Journal of Gastroenterology 3 (2013) 38-41
40
functions (i.e. chemotaxis, protein folding) [29]. Indeed,
some molecules have shown a very high bactericidal
level of activity against H. pylori in vitro and some
molecules preserve antibacterial activity even at low pH
values as needed in the presence of gastric acid.
5. CONCLUSION
The best treatment for the eradication of H. pylori is still
lacking. It is well known that standard triple therapy has
a poor efficacy to cure the infection because of the in-
creased resistance to clarithromycin which is the key
antibiotic. Nevertheless current guidelines still recom-
mend this treatment in areas with low clarithromycin
resistance (less than 15% - 20%). In those areas where
the resistance is higher sequential, quadruple or con-
comitant therapies are recommended for first-line em-
pirical treatment. New therapeutic targets are now under
consideration but currently there is still no answer to the
question about what is the best replacement for Helico-
bacter pylori eradication therapy.
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