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Introduction Helicobacter pylori infection is one of the most common infectious diseases worldwide, and the most common cause of gastric, duodenal ulcer and gastric cancer.
In 2020, Korean scholars updated the clinical practice guidelines for the treatment of Helicobacter pylori.
This guideline mainly provides guidance and recommendations for the treatment of Helicobacter pylori infection.
Treatment of Helicobacter pylori infection: 2020 Korean Evidence-Based Guidelines 1.
New indications for Helicobacter pylori eradication Statement 1: Eradication of Helicobacter pylori can help improve anemia in adults with unexplained iron deficiency anemia (IDA).
Strength of Recommendation: Weak; Level of Evidence: Very Low Statement 2: For Helicobacter pylori-positive gastric adenomas, it is recommended to eradicate Helicobacter pylori after endoscopic resection (ER) to prevent metachronous recurrence.
Strength of recommendation: weak; Level of evidence: low Statement 3: It is recommended to eradicate Helicobacter pylori for long-term improvement of dyspeptic symptoms in patients with functional dyspepsia.
Strength of recommendation: weak; Level of evidence: Senior two, Helicobacter pylori eradication treatment statement 4: Recommend standard triple therapy [standard dose of proton pump inhibitor (PPI) + amoxicillin 1 g + clarithromycin 500 mg, twice a day] Treatment for 14 days is the first-line treatment plan.
Strength of Recommendation: Strong; Level of Evidence: Moderate Statement 5: Sequential therapy (standard dose of PPI + amoxicillin 1 g twice a day for 5 days, then change to standard dose of PPI + clarithromycin 500 mg + metronidazole 500 mg each 2 times a day for 5 days) can be used as one of the first-line treatments for Helicobacter pylori eradication.
Strength of Recommendation: Strong; Level of Evidence: High Statement 6: Concomitant therapy (standard dose of PPI + clarithromycin 500 mg + amoxicillin 1 g + metronidazole 500 mg, twice a day for 10 days) is recommended as the first-line treatment.
Strength of Recommendation: Strong; Level of Evidence: High Statement 7: When standard triple therapy treatment for 7 days is used as the first-line treatment, clarithromycin resistance test by polymerase chain reaction (PCR) or sequence determination is recommended.
Strength of recommendation: strong; level of evidence: low Statement 8: bismuth quadruple therapy (standard dose of PPI 2 times a day + metronidazole 500 mg 3 times a day + bismuth 120 mg and tetracycline 500 mg 4 times a day, continuous The eradication rate of 10-14 days) is similar to the eradication rate of standard triple therapy for 14 days, concomitant therapy for 10 days, and sequential therapy for 10 days.
However, due to its high adverse reactions and potential use as a second-line treatment, when other first-line treatment options are not available, bismuth quadruple therapy is recommended as a first-line treatment option.
Strength of recommendation: weak; Level of evidence: moderate Statement 9: After the failure of standard triple therapy, bismuth quadruple therapy (PPI + bismuth + tetracycline + metronidazole) is recommended as a second-line treatment for 14 days.
Strength of Recommendation: Strong; Level of Evidence: High Statement 10: After the failure of non-bismuth quadruple therapy (sequential or concomitant therapy), bismuth quadruple therapy is recommended as a second-line treatment.
Strength of Recommendation: Strong; Level of Evidence: Very Low Statement 11: After the failure of bismuth quadruple therapy as a first-line or second-line treatment (after the failure of standard triple or non-bismuth quadruple therapy), levofloxacin triple therapy is recommended as a rescue treatment.
Strength of Recommendation: Weak; Level of Evidence: Very Low Literature Index: Jung HK, Kang SJ, Lee YC, et al.
Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea 2020[J].
Gut Liver.
2021 Mar 15; 15(2):168-195.
Contribution email: tougao@medlive.
cn
In 2020, Korean scholars updated the clinical practice guidelines for the treatment of Helicobacter pylori.
This guideline mainly provides guidance and recommendations for the treatment of Helicobacter pylori infection.
Treatment of Helicobacter pylori infection: 2020 Korean Evidence-Based Guidelines 1.
New indications for Helicobacter pylori eradication Statement 1: Eradication of Helicobacter pylori can help improve anemia in adults with unexplained iron deficiency anemia (IDA).
Strength of Recommendation: Weak; Level of Evidence: Very Low Statement 2: For Helicobacter pylori-positive gastric adenomas, it is recommended to eradicate Helicobacter pylori after endoscopic resection (ER) to prevent metachronous recurrence.
Strength of recommendation: weak; Level of evidence: low Statement 3: It is recommended to eradicate Helicobacter pylori for long-term improvement of dyspeptic symptoms in patients with functional dyspepsia.
Strength of recommendation: weak; Level of evidence: Senior two, Helicobacter pylori eradication treatment statement 4: Recommend standard triple therapy [standard dose of proton pump inhibitor (PPI) + amoxicillin 1 g + clarithromycin 500 mg, twice a day] Treatment for 14 days is the first-line treatment plan.
Strength of Recommendation: Strong; Level of Evidence: Moderate Statement 5: Sequential therapy (standard dose of PPI + amoxicillin 1 g twice a day for 5 days, then change to standard dose of PPI + clarithromycin 500 mg + metronidazole 500 mg each 2 times a day for 5 days) can be used as one of the first-line treatments for Helicobacter pylori eradication.
Strength of Recommendation: Strong; Level of Evidence: High Statement 6: Concomitant therapy (standard dose of PPI + clarithromycin 500 mg + amoxicillin 1 g + metronidazole 500 mg, twice a day for 10 days) is recommended as the first-line treatment.
Strength of Recommendation: Strong; Level of Evidence: High Statement 7: When standard triple therapy treatment for 7 days is used as the first-line treatment, clarithromycin resistance test by polymerase chain reaction (PCR) or sequence determination is recommended.
Strength of recommendation: strong; level of evidence: low Statement 8: bismuth quadruple therapy (standard dose of PPI 2 times a day + metronidazole 500 mg 3 times a day + bismuth 120 mg and tetracycline 500 mg 4 times a day, continuous The eradication rate of 10-14 days) is similar to the eradication rate of standard triple therapy for 14 days, concomitant therapy for 10 days, and sequential therapy for 10 days.
However, due to its high adverse reactions and potential use as a second-line treatment, when other first-line treatment options are not available, bismuth quadruple therapy is recommended as a first-line treatment option.
Strength of recommendation: weak; Level of evidence: moderate Statement 9: After the failure of standard triple therapy, bismuth quadruple therapy (PPI + bismuth + tetracycline + metronidazole) is recommended as a second-line treatment for 14 days.
Strength of Recommendation: Strong; Level of Evidence: High Statement 10: After the failure of non-bismuth quadruple therapy (sequential or concomitant therapy), bismuth quadruple therapy is recommended as a second-line treatment.
Strength of Recommendation: Strong; Level of Evidence: Very Low Statement 11: After the failure of bismuth quadruple therapy as a first-line or second-line treatment (after the failure of standard triple or non-bismuth quadruple therapy), levofloxacin triple therapy is recommended as a rescue treatment.
Strength of Recommendation: Weak; Level of Evidence: Very Low Literature Index: Jung HK, Kang SJ, Lee YC, et al.
Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea 2020[J].
Gut Liver.
2021 Mar 15; 15(2):168-195.
Contribution email: tougao@medlive.
cn
