Treating Helicobacter pylori effectively while minimizing misuse of antibiotics

Helicobacter pylori infection is an infectious disease and should be treated like one, with due consideration of antibiotic resistance and stewardship.1–4 This was the consensus of the 2015 Kyoto H pylori conference,2 and it signaled a fundamental shift in thinking. Up to now, H pylori treatment has not been based on infectious disease principles, leading to suboptimal results and antibiotic resistance. In addition, the conference recommended that H pylori infection be treated whenever it is found unless there are compelling reasons not to. Here we review current and possible future regimens for eradicating H pylori that we hope will be more effective and will lead to less resistance than in the past.