Treating Patients Who Have Helicobacter pylori Infections

Among other changes, the 2024 version of these guidelines suggests that clinicians use clarithromycin and levofloxacin to treat H. pylori only if susceptibility is proven.

Sponsoring Organization: American College of Gastroenterology (ACG)

Background

The ACG last issued guidelines for managing Helicobacter pylori infections in 2017 (NEJM JW Gastroenterol Mar 2017 and Am J Gastroenterol 2017; 112:212). This 2024 revision was prompted by rising resistance rates to antibiotics often used for treatment, availability of a new class of gastric acid suppressants, and increasing use of antibiotic susceptibility testing.

Key Recommendations

Because of the association of chronic H. pylori infection with gastric malignancy, all patients who test positive should be treated.
For a patient with a first infection, the preferred regimen is a 14-day course of a bismuth salt, metronidazole or tinidazole, tetracycline, and a proton-…

Reviewing Author

Abigail Zuger, MD

Disclosures

Nothing to disclose

Abigail Zuger, MD

Disclosures

Nothing to disclose

Treating Patients Who Have Helicobacter pylori Infections

Topics

Background

Key Recommendations

Reviewing Author