IV Spanish Consensus Conference on Helicobacter pylori infection treatment

Gastroenterol Hepatol. 2016 Dec;39(10):697-721. doi: 10.1016/j.gastrohep.2016.05.003. Epub 2016 Jun 21.
[Article in English, Spanish]

Abstract

Helicobacter pylori approximately infect 50% of Spanish population and causes chronic gastritis, peptic ulcer and gastric cancer. Until now, three consensus meetings on H.pylori infection had been performed in Spain (the last in 2012). The changes in the treatment schemes, and the increasing available evidence, have justified organizing the IVSpanish Consensus Conference (March 2016), focused on the treatment of this infection. Nineteen experts participated, who performed a systematic review of the scientific evidence and developed a series of recommendation that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. As starting point, this consensus increased the minimum acceptable efficacy of recommended treatments that should reach, or preferably surpass, the 90% cure rate when prescribed empirically. Therefore, only quadruple therapies (with or without bismuth), and generally lasting 14 days, are recommended both for first and second line treatments. Non-bismuth quadruple concomitant regimen, including a proton pump inhibitor, clarithromycin, amoxicillin and metronidazole, is recommended as first line. In the present consensus, other first line alternatives and rescue treatments are also reviewed and recommended.

Keywords: Bismuth; Bismuto; Clarithromycin; Claritromicina; Helicobacter pylori; Inhibidor de la bomba de protones; Metronidazol; Metronidazole; Omeprazol; Omeprazole; Proton pump inhibitor.

Publication types

  • Consensus Development Conference
  • Practice Guideline
  • Systematic Review

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / therapeutic use
  • Bismuth / therapeutic use
  • Clinical Trials as Topic
  • Delphi Technique
  • Drug Therapy, Combination
  • Gastritis / complications
  • Gastritis / drug therapy*
  • Gastritis / microbiology
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori* / drug effects
  • Helicobacter pylori* / isolation & purification
  • Helicobacter pylori* / pathogenicity
  • Humans
  • Meta-Analysis as Topic
  • Probiotics
  • Proton Pump Inhibitors / therapeutic use
  • Recurrence
  • Salvage Therapy
  • Stomach Neoplasms / etiology
  • Stomach Neoplasms / prevention & control
  • Stomach Ulcer / etiology
  • Stomach Ulcer / prevention & control
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Bismuth