Table 3

Recommendations for H pylori eradication formulated in the Maastricht III Consensus Report, with levels of scientific evidence and grades of recommendation

Recommendations	Level of evidence	Grade of recommendation
H pylori eradication is an appropriate option for patients infected with H pylori and investigated non-ulcer dyspepsia	1a	A

H pylori test and treat is an appropriate option for patients with uninvestigated dyspepsia	1a	A

Effectiveness of H pylori test and treat is low in populations with a low H pylori prevalence. In this situation the test and treat strategy or empirical acid suppression is an appropriate option	2a	B

H pylori eradication does not cause GORD	1b	A

H pylori eradication does not affect the outcome of PPI treatment in patients with GORD in Western populations	1b	A
Routine testing for H pylori is not recommended in GORD	1b	A
H pylori testing should be considered for patients receiving long term maintenance treatment with PPIs	2b	B

There is a negative association between the prevalence of H pylori and GORD in Asia, but the nature of this relationship is uncertain	2b	B

In patients receiving long term NSAIDs and who have peptic ulcer and/or ulcer bleeding, PPI maintenance treatment is better than H pylori eradication in preventing ulcer recurrence and/or bleeding	1b	A

H pylori eradication is of value in chronic NSAID users but is insufficient to prevent NSAID related ulcer disease completely	1b	A

In naïve users of NSAIDs, H pylori eradication may prevent peptic ulcer and or bleeding	1b	A