Sequential therapy; a new treatment for Helicobacter pylori infectionBut is it ready for general use?

Abstract

According to the WHO, Helicobacter pylori is a class I carcinogen and therefore leaving a diagnosed infection untreated is generally considered to be unethical. Thus, a physician ordering a diagnostic Helicobacter test needs to be prepared to treat all the individuals who test positive, and if not, then he should not order the test. Furthermore, once it is established that a patient is infected, evidence suggests that its eradication is cheaper and is associated with better long-term improvement than the empiric proton pump inhibitor (PPI) therapy [1,2]. A “test for Helicobacter & treat the positives”-strategy for young dyspeptic patients has been shown to be a cost-effective alternative for endoscopy in primary care patients with dyspepsia [3,4]. It is now recommended in several national and international guidelines, including the European consensus report [5]. With infection rates of H. pylori infection still being high, the implementation of these guidelines would not only result in an increasing number of the diagnostic tests, but would also lead to an increasing number of patients who would be in need of eradication therapy.