Antibiotic-Free Helicobacter Pylori Eradication – Case Reports and Review of The Literature

Abstract

Background: Standard Helicobacter pylori eradication therapy is based on proton pump inhibitors and antibiotics. There are, however, important limitations: increasing antibiotic resistance of Helicobacter pylori, medical contraindications, and an increasing unwillingness among patients to use antibiotics. Case presentations: We present three exemplary case reports of successful antibiotic-free Helicobacter pylori eradication therapies, one for each of these limiting categories: a 61-year-old female Caucasian patient refractory to prior eradication therapy, an 80-year-old female Caucasian patient with contraindication to antibiotics, and a 41-year-old male Caucasian patient refusing antibiotics. A review of the literature attempts to provide a scientific rationale for proton pump inhibitor-based and probiotics-supported Helicobacter pylori eradication. Conclusion: Antibiotics-free Helicobacter pylori eradication may offer a therapeutic option for patients in whom classical eradication therapy cannot be conducted or who are refractory to antibiotics. Clinical trials are needed to scientifically evaluate the concept presented here.