What family practitioners ought to know about management of Helicobacter pylori infection

This article reviews the current recommendations for diagnosis and management of Helicobacter pylori (Hp) infection based on agreement in the Maastricht V/Florence Consensus Report and the Kyoto Global Consensus on Hp gastritis. It was underlined that Hp gastritis is accepted as an infectious disease irrespective of symptoms and complications. Helicobacter pylori-associated dyspepsia is a distinct entity. Helicobacter pylori infection is a major aetiological factor for gastric cancer, and Hp eradication reduces the risk of cancer development. PPI-clarithromycin-containing triple therapy should be abandoned when the clarithromycin resistance rate in the region is more than 15%. In these areas bismuth quadruple or non-bismuth quadruple therapies are recommended. In areas of high dual clarithromycin and metronidazole resistance, bismuth quadruple therapy is the recommended first-line treatment. It is worth underlining that every patient should be individually considered according to the kind of treatment and its likely complications.