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The recent review by Salcedo and Al-Kawas¹ may cause confusion in the minds of many physicians. The European Helicobacter pylori Study Group and the 1997 International Update Conference organized under the auspices of the American Digestive Health Foundation both recommended specific combination drug regimens against H pylori infection.^2-3 Appropriate eradication rates are considered to be 90% or higher on a per-protocol analysis and 80% or higher on an intent-to-treat analysis.² Many of the regimens reviewed by Salcedo and Al-Kawas fail to meet these goals and do not deserve further consideration; there is no point in educating physicians about inadequate or obsolete therapies except to stress that they should be avoided.

Therefore, it is not helpful to consider single agents for H pylori infection. Although the authors do not recommend monotherapy, it should be made clear to nonspecialists that the use of a single agent is specifically contraindicated. While it is . . . [Full Text of this Article]