MINI REVIEW article
Front. Microbiol.
Sec. Antimicrobials, Resistance and Chemotherapy
Therapeutic Advances and Future Directions in Helicobacter pylori Eradication
Provisionally accepted
- 1Amrita Vishwa Vidyapeetham Amrita Centre for Nanosciences and Molecular Medicine, Kochi, India
- 2Amrita Institute of Medical Sciences, Kochi, India
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Helicobacter pylori (H. pylori) is a globally prevalent pathogen associated with a spectrum of gastrointestinal diseases, including chronic gastritis, peptic ulcer disease, and gastric malignancies. Although clarithromycin-based triple therapy continues to be effective in certain geographic areas, increasing global resistance highlights the need for treatment approaches tailored to local antibiotic susceptibility patterns. Recent clinical trials have shifted toward optimized quadruple regimens, particularly bismuth-and vonoprazan-based therapies, and resistance-guided treatment. Novel agents such as Rifasutenizol (TNP-2198) are entering phase 3 evaluation and show activity against multidrug-resistant strains. Adjunctive and alternative strategies including probiotics, phytochemicals, phage-derived enzymes, and nanoparticle-based delivery demonstrate synergistic effects in improving eradication and reducing antibiotic-associated adverse events. Multi-strain probiotic formulations and plant-derived compounds such as curcumin, catechins, and quercetin consistently suppress H. pylori virulence pathways and gastric inflammation in clinical and preclinical studies. This review provides an overview of current evidence from clinical trials and emerging therapeutic innovations, emphasizing balanced integration of conventional and next-generation approaches for sustainable global H. pylori management.
Keywords: Helicobacter pylori, Eradication therapy, antibiotic resistance, clinical trials, Quadruple therapy, Vonoprazan, Probiotic adjuncts, phage therapy
Received: 06 Jul 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Suresh, S, Kumar, Sadasivan, Biswas and Biswas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Raja Biswas, rajabiswas@acnsmm.aims.amrita.edu
Lalitha Biswas, lalithabiswas@aims.amrita.edu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.