Testing options for H. pylori

Identified in 1983 by Australian Nobel prize winners Marshall and Warren, H. pylori is linked to a spectrum of disease including non-ulcer dyspepsia, peptic ulcer, gastric cancer and mucosa-associated lymphoid tissue lymphoma.

Infection is estimated to be present in about 30% of adult Australians, though not uniformly distributed in the population. Prevalence is higher in immigrants, those of lower socioeconomic status and the institutionalised.

It has been conventionally treated with a standard first-line triple therapy including a proton pump inhibitor (PPI), clarithromycin and amoxicillin or metronidazole administered for seven days.

However, in the past decade the effectiveness of this triple therapy, although still recommended in Therapeutic Guidelines, has declined mainly due to the development of antibiotic resistance.

A recent meta-analysis1 of treatment, which reviewed ...

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