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

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 manycases, faces rising failure rates due to antibiotic resistance, patientnon-compliance, and adverse side effects. Quadruple and sequentialtherapies have been introduced, utilising additional agents like bismuthand adjusting antibiotic administration. However, these regimens stillconfront challenges, including drug resistance and high recurrence rates.Probiotics, particularly Lactobacillus strains, have emerged as potentialadjuncts to standard therapy, and they have been shown to enhanceeradication rates and reduce side effects. Alternative therapies likevonoprazan, a potassium-competitive acid blocker, and personaliseddosing based on body size and genetic factors, particularly CYP2C19variations, are under investigation to optimise efficacy. Innovativestrategies, such as antibiotic stewardship guided by susceptibilitytesting, have also been proposed to enhance treatment outcomeswhile mitigating resistance. Patient education on adherence and propermedication usage has been shown to significantly impact eradicationsuccess rates. Additionally, broad eradication programmes aimed athigh-risk populations have demonstrated substantial reductions ingastric cancer incidence and mortality, emphasising lifestyle adjustmentsand early detection. As research advances, future therapies mayinclude antivirulence agents targeting H. pylori’s virulence factors andnew mucolytic drugs, promising better outcomes while preserving gutmicrobiota. Overall, a multifaceted approach incorporating personalisedmedicine, probiotic adjuncts, and patient-focused strategies appearsessential for effectively managing H. pylori infection and minimisingassociated health risks.How to cite this article:Arun A, Rajesh N, Sreedevi M, Kardar K, RakeshA, Suresh S, Unnikrishnan V, Nawal A G, Menon L.Helicobacter pylori Eradication Therapies: CurrentStrategies and Future Perspectives in Peptic UlcerDisease. J Commun Dis. 2025;57(1):191-196. DOI: https://doi.org/10.24321/0019.5138.202524