The actions of bismuth in the treatment of Helicobacter pylori infections: an update

Helicobacter pylori causes various gastric diseases, such as gastritis, peptic ulcerations and gastric cancer. Bismuth-based triple or quadruple therapies have been commonly recommended for the treatment of H. pylori infections. Up to now, the molecular mechanisms by which bismuth inhibits the growth of H. pylori are far from clear. The present concise review intends to cover the most recent reports and discoveries in the field of the inhibitory mechanism of bismuth against H. pylori as well as the bacterial protective response to drug treatment, which will help us to further understand the molecular mechanisms underlying the actions of metal-based drugs and stimulate further development of effective anti-bacterial drugs.