Overview
Helicobacter pylori is a common infectious disease globally that can lead to dyspepsia, peptic ulcer disease, and gastric cancer 12. Management strategies are evolving due to changing antimicrobial resistance patterns 2.Diagnosis
No specific diagnostic criteria or recommended tests were detailed in the provided abstracts.Management
Treatment-Naive Patients:
* Bismuth quadruple therapy (BQT) for 14 days is preferred when antibiotic susceptibility is unknown 1.
* Rifabutin triple therapy or potassium-competitive acid blocker dual therapy for 14 days are suitable empiric alternatives in patients without penicillin allergy 1.
Treatment-Experienced Patients:
* "Optimized" BQT for 14 days is preferred for those not previously treated with it and when antibiotic susceptibility is unknown 1.
* Rifabutin triple therapy for 14 days is a suitable empiric alternative for patients previously treated with optimized BQT 1.
* Salvage regimens containing clarithromycin or levofloxacin should only be used if antibiotic susceptibility is confirmed 1.Special Populations
No specific information was provided for special populations.Key Recommendations
For treatment-naive patients with H. pylori infection, bismuth quadruple therapy for 14 days is the preferred regimen when antibiotic susceptibility is unknown 1. (Evidence: Strong)
In treatment-experienced patients with persistent H. pylori infection, "optimized" bismuth quadruple therapy for 14 days is preferred for those who have not been treated with optimized BQT previously and for whom antibiotic susceptibility is unknown 1. (Evidence: Strong)
Rifabutin triple therapy or potassium-competitive acid blocker dual therapy for 14 days is a suitable empiric alternative in treatment-naive patients without penicillin allergy 1. (Evidence: Moderate)References
1 Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S et al.. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American journal of gastroenterology 2024. link
2 Katelaris P, Hunt R, Bazzoli F, Cohen H, Fock KM, Gemilyan M et al.. Helicobacter pylori World Gastroenterology Organization Global Guideline. Journal of clinical gastroenterology 2023. link