PERSONALIZED THERAPY FOR HELICOBACTER PYLORI INFECTION—PRESENT STATUS AND ISSUES

Abstract

Personalized therapy for Helicobacter pylori eradication comprises optimal antimicrobial agents selected not only according to susceptibility testing but also individual patient characteristics, such as drug hypersensitivity and interactions with co-administered drugs. The eradication rate of the first-line treatment has been reportedly improved by personalized therapy using antibacterial agents selected based on bacterial susceptibility testing. In third-line therapy, a sitafloxacin-containing regimen is often used. For patients allergic to penicillin, a combination of metronidazole and clarithromycin or sitafloxacin is often prescribed. However, clarithromycin and metronidazole require caution in terms of their interaction with other concomitant drugs. Moreover, first- and second-line regimens for H. pylori eradication are inflexible in Japan’s health insurance guidelines. They should be modified to accommodate individual cases.