Treatment of Helicobacter pylori.

Overwhelming evidence implicates Helicobacter pylori as a significant causative factor in many gastroduodenal diseases. Effective multidrug antimicrobial regimens are available for cure of the infection, so investigative efforts are focusing on cost-effectiveness and treatment outcome in various populations. Potential associations between H. pylori and nongastric disorders are being examined. Recognition that infection is largely acquired during childhood has emphasized the need to study pediatric issues. Posttreatment studies confirm the importance of the bacterium in pathogenesis and relapse of peptic ulcer disease. Antimicrobial resistance has a negative impact on cure of the infection and healing of gastroduodenal lesions. Methodology to evaluate H. pylori antimicrobial susceptibility has been standardized by the National Committee for Clinical Laboratory Standards, and minimum inhibitory concentration breakpoints to standardize resistance assays are being established. Surveillance of H. pylori antimicrobial resistance is underway in a Centers for Disease Control and Prevention multisite project in the United States.