Campylobacter pylori-associated gastritis. Is antibiotic therapy now justified?

Campylobacter pylori clearly is a common inhabitant of the human stomach and is associated with nonautoimmune antral gastritis, chronic peptic ulceration, and non-ulcer dyspepsia. This editorial reviews whether therapy is now justified for patients with this infection. The criteria that must be fulfilled before an association can be considered to be of etiologic significance are discussed in relation to C. pylori infection and clinical disease. An overview of therapeutic approaches to eradicate C. pylori is presented, emphasizing their limitations and hazards. It is concluded that prescribing treatment for C. pylori infection outside the setting of a controlled trial is currently not appropriate.