Abstract

ALTERNATIVE THERAPIES BEYOND ANTIBIOTICS: HELICOBACTER PYLORI ERADICATION

Neena Garg*

ABSTRACT

Helicobacter pylori is a Gram-negative human gastric pathogen infecting about 30% of children and 60% of adults worldwide and has a possible etiologic role in peptic and gastric ulcers, gastric adenocarcinoma and more rarely, lymphoma of the mucosa-associated lymphoid tissue. Currently, this is managed by the use of a triple therapy, involving the co-administration of two antibiotics (with macrolides, fluoroquinolones, amoxicilin, nitroimidazoles and tetracycline among the most prescribed ones) and ranitidine bismuth and/or a proton pump inhibitor. However, as for other bacteria, during the last decades we have been observing the continuous growth of the number of antibiotic resistant H. pylori strains, especially in countries in which antibiotic prescription is more common. The high prevalence rates worldwide and the real risk of severe gastric diseases development demand the need for good strategies for H. pylori eradication. Still growing antibiotic resistance rate already leads to treatment failure in about 20% of the H. pylori-infected patients, but depending on the therapeutic schema and strain resistance pattern, the failure rate can reach 70%, which has led to the search for alternative therapies. This review focuses on the state of the art of alternative strategies for combating H. pylori infection, not involving the use of antibiotics, currently under investigation, namely vaccines, bacterial photodynamic inactivation, phage therapy, the use of probiotics and natural compounds.

Keywords: Helicobacter pylori; Probiotics; Bacteriocin; Vaccines; Phage therapy.