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Abstract :

This review is a comprehensive summary of different variants of anti-Helicobacter pylori therapy from past strategies to the current state of the art. Nowadays we see a progressive decreasing of eradication rate in many countries in case of use standard triple therapy. It can be associated with high clarithromycin resistance of Helicobacter pylori. Gradual increase in number of the used antibiotics, the increase in duration of treatment, use of new antibacterial compounds and schemes of treatment do not lead to a long-term positive effect on eradication rate and on preservation of risk of development of side reactions. It is necessary to pay active attention to new approaches to treatment and alternative options of therapy of an Helicobacter pylori infection. One of the most perspective methods of improving the efficacy of eradication can be the usage of probiotics, especially in addition to standard therapy. Probiotics have some mechanisms to influence on Helicobacter pylori: lactic acid production, synthesis of bacteriocins and antimicrobial metabolites, concurrence for adhesion sites, the reparation of the barrier function of the stomach mucosa, a decrease of inflammation and increase of immunity of infected humans. Bismuth subcitrate is very effective in eradication, cytoprotection, and atrophic changes regression and can be recommended for eradication schemes as classic quadrotherapy also as a 4th additional component in classic triple therapy.