To date, it remains controversial whether to test and treat all patients with functional dyspepsia, gastroesophageal reflux disease, or other non-GI disorders as well as asymptomatic individuals.
[1] The success of H. pylori cure depends on the type and duration of therapy, patient compliance and bacterial factors such as antibiotic resistance.
[4] A 14-day course of "quadruple therapy" with a proton pump inhibitor, bismuth, tetracycline, and metronidazole or tinidazole is a more complicated but also more effective regimen.
However, subsequent studies confirmed equivalent or superior efficacy when all four drugs were given concomitantly for 10 days (non-bismuth quadruple therapy).
[7] Although initial studies promisingly reported higher eradication rates,[3] there is no superiority compared to the other therapies except in the presence of clarithromycin resistant organisms.
[citation needed] A 2016 systematic review has found that periodontal therapy (the use of mouthwash, tooth brushing, and manual removal of dental plaques) may have a role as an added treatment for short- and long-term follow up.
[11] Some studies have recently evaluated the role of the yeast Saccharomyces boulardii as a coadjutant in the eradication of H. pylori and in the prevention of the secondary effects of antibiotic therapy such as antibiotic-associated diarrhea.
and Lactobacillus acidophilus have been administered revealed no significant difference in eradication rates in patients who were infected with strains susceptible to both antibiotics and who were treated with standard triple therapy.
[citation needed] One of the first "modern" eradication protocols was a one-week triple therapy, which the Sydney gastroenterologist Thomas Borody formulated in 1987.
[14] As of 2006, a standard triple therapy is amoxicillin, clarithromycin, and a proton pump inhibitor such as omeprazole,[15] lansoprazole, pantoprazole, or esomeprazole.