Table 3

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

RecommendationsLevel of evidenceGrade of recommendation
H pylori eradication is an appropriate option for patients infected with H pylori and investigated non-ulcer dyspepsia1aA
H pylori test and treat is an appropriate option for patients with uninvestigated dyspepsia1aA
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 option2aB
H pylori eradication does not cause GORD1bA
H pylori eradication does not affect the outcome of PPI treatment in patients with GORD in Western populations1bA
Routine testing for H pylori is not recommended in GORD1bA
H pylori testing should be considered for patients receiving long term maintenance treatment with PPIs2bB
There is a negative association between the prevalence of H pylori and GORD in Asia, but the nature of this relationship is uncertain2bB
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 bleeding1bA
H pylori eradication is of value in chronic NSAID users but is insufficient to prevent NSAID related ulcer disease completely1bA
In naïve users of NSAIDs, H pylori eradication may prevent peptic ulcer and or bleeding1bA