| [ Summary ] |
Gastric acid inhibition is one of the key factors associated with the success or failure of eradication of H. pylori. Gastric acid inhibition makes anti‒microbial agents more stable and bioavailable in the stomach. However, when a PPI is used as the acid inhibitor in H. pylori eradication therapy, the eradication rates are lower in rapid metabolizers of CYP2C19. The new acid inhibitor, vonoprazan, classified into the potassium competitive acid blocker (P-CAB), inhibits gastric acid secretion more potently in comparison with PPIs. The eradication rates of H. pylori attained by vonoprazan‒based regimens have been reported to be higher than those by PPI‒based regimens. Particularly, the eradication rates of clarithromycin‒resistant strains of H. pylori are fairly good. Therefore, dual therapy with vonoprazan and amoxicillin is expected to attain sufficient eradication rates without a second antimicrobial agent. |