Helicobacter pylori Eradication Therapies: Current Strategies and Future Perspectives in Peptic Ulcer Disease

Abstract

Helicobacter pylori (H. pylori) infection is a significant global health

concern, linked to peptic ulcers, gastric adenocarcinoma, and mucosa-
associated lymphoid tissue lymphoma. Standard triple therapy with

proton pump inhibitors (PPIs) and antibiotics, while effective in many
cases, faces rising failure rates due to antibiotic resistance, patient
non-compliance, and adverse side effects. Quadruple and sequential
therapies have been introduced, utilising additional agents like bismuth
and adjusting antibiotic administration. However, these regimens still
confront challenges, including drug resistance and high recurrence rates.
Probiotics, particularly Lactobacillus strains, have emerged as potential
adjuncts to standard therapy, and they have been shown to enhance
eradication rates and reduce side effects. Alternative therapies like
vonoprazan, a potassium-competitive acid blocker, and personalised
dosing based on body size and genetic factors, particularly CYP2C19
variations, are under investigation to optimise efficacy. Innovative
strategies, such as antibiotic stewardship guided by susceptibility
testing, have also been proposed to enhance treatment outcomes
while mitigating resistance. Patient education on adherence and proper
medication usage has been shown to significantly impact eradication
success rates. Additionally, broad eradication programmes aimed at
high-risk populations have demonstrated substantial reductions in
gastric cancer incidence and mortality, emphasising lifestyle adjustments
and early detection. As research advances, future therapies may
include antivirulence agents targeting H. pylori’s virulence factors and
new mucolytic drugs, promising better outcomes while preserving gut
microbiota. Overall, a multifaceted approach incorporating personalised
medicine, probiotic adjuncts, and patient-focused strategies appears
essential for effectively managing H. pylori infection and minimising
associated health risks.
How to cite this article:
Arun A, Rajesh N, Sreedevi M, Kardar K, Rakesh
A, Suresh S, Unnikrishnan V, Nawal A G, Menon L.
Helicobacter pylori Eradication Therapies: Current
Strategies and Future Perspectives in Peptic Ulcer
Disease. J Commun Dis. 2025;57(1):191-196.

DOI: https://doi.org/10.24321/0019.5138.202524