Table 4.

Guidelines to implement antimicrobial stewardship for treatment of H. pylori infections

Therapies must be optimized to reliably achieve high cure rates.

Optimization should include information regarding the effects of resistance to the different components and should be confirmed when used in a different region.

Surveillance of treatment success should be instituted. This should include tests of cure and, preferably, with susceptibility testing available for treatment failures.

Treatment of H. pylori should be integrated with ongoing or planned prescription and treatment monitoring programs utilized for other bacterial infections.

Data from sites where culture and susceptibility testing and/or molecular testing are done locally should be published and kept up to date.

Susceptibility testing should be reimbursed as for other bacterial pathogens and the results data should be submitted to local and central repositories responsible for monitoring resistance among bacterial pathogens.

To avoid unethical studies, studies should adhere to the guidelines of the Infectious Diseases Society of America regarding conduct of superiority and organism-specific clinical trials of antibacterial agents for the treatment of infections caused by drug-resistant bacterial pathogens.

From reference ⁴ with permission.