2022 Chinese National Clinical Practice Guideline on Helicobacter pylori Eradication Treatment / 胃肠病学

ABSTRACT

Helicobacter pylori (Hp) infection is an infectious disease with a prevalence rate of up to 50% worldwide. It can cause dyspepsia, gastritis, peptic ulcer disease and gastric cancer. Hp eradication treatment can effectively control disease progression and reduce risk of the diseases. However, the escalating trend of antibiotic resistance presents a global challenge for Hp eradication. Though decreasing in developed countries, the prevalence of Hp infection remains high in developing countries, causing a major public health burden. This clinical practice guideline (CPG) is made to provide guidance on the eradication treatment of Hp infection. This CPG is developed following the World Health Organization’s recommended process, adopting grading of recommendations assessment, development, and evaluation (GRADE) in assessing evidence quality and utilizing its evidence to decision framework to formulate clinical recommendations, so as to minimize bias and increase transparency of the CPG development process. The Reporting Items for Practice Guidelines in Healthcare (RIGHT) statement and Appraisal of Guidelines for Research and Evaluation II (AGREE II) are used as reporting and execution guidance to ensure its completeness and transparency. This CPG contains 12 recommendations concerning eradication treatment of Hp infection. Among them, it is worth highlighting that bismuth preparations are safe, effective and inexpensive, consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatments. In empirical initial treatment, high dose dual therapy is equally effective as bismuth quadruple therapy. The 12 recommendations in this CPG are formed with consideration to stakeholders’values and preferences, resource availability, feasibility and acceptability. These recommendations are generally applicable to resource limited settings with similar antibiotic resistance pattern as China, and status with comparable sociological and technical challenges.