The search is still on for the simplest, shortest, most effective, and best tolerated regimen

The rediscovery of Helicobacter pylori has revolutionised our therapeutic approach to peptic ulcer. Although the pathogenetic link between infection with H pylori and the formation of ulcers is still unclear, eradicating the organism dramatically reduces relapses of ulcers. This has prompted many investigators to find the best eradicating regimen.

Treatments against the bacterium have evolved rapidly over the past few years, even though most current information comes from small clinical trials, often published only in abstract form. Despite this limitation rates of eradication have continually improved, and nowadays we should adopt only eradicating regimens that achieve at least 90% success.1

As the bacterium responds poorly to monotherapy, combinations of two, three, or four drugs have been studied intensively. Until recently a 14 day course of a bismuth compound, metronidazole, and either amoxycillin or …