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 |