Photo Credit: Artur Plawgo
The following is a summary of “ACG Clinical Guideline: Treatment of Helicobacter pylori Infection,” published in the September 2024 issue of Gastroenterology by Chey et al.
Helicobacter pylori (H. Pylori) is a common global infection that can lead to dyspepsia, peptic ulcers, and gastric cancer. The American College of Gastroenterology (ACG) developed guidelines for managing H. pylori infection in North America.
Researchers conducted a prospective study to provide evidence-based treatment recommendations for managing H. pylori infection in North Americans.
They applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology to analyze 11 Population, Intervention, Comparison, and Outcome questions. When evidence was lacking, expert consensus generated 6 key concepts. They recommended treatment regimens for both treatment-naive and treatment-experienced patients with H. pylori infection, with considerations for antibiotic susceptibility.
The results showed that bismuth quadruple therapy (BQT) for 14 days is preferred for treatment-naive patients when antibiotic susceptibility is unknown. Rifabutin triple therapy or potassium-competitive acid blocker dual therapy for 14 days is recommended as an alternative for patients without penicillin allergy. In treatment-experienced patients, “optimized” BQT is preferred if they have not previously received it. Rifabutin triple therapy is a suitable alternative, while salvage regimens containing clarithromycin or levofloxacin should be used only if antibiotic susceptibility is confirmed.
The study concluded that BQT is the preferred regimen for , with alternatives based on prior treatments and antibiotic susceptibility.
Source: journals.lww.com/ajg/fulltext/2024/09000/acg_clinical_guideline__treatment_of_helicobacter.13.aspx
