Expert Consensus
Copyright ©The Author(s) 2025.
World J Gastroenterol. Jul 21, 2025; 31(27): 107138
Published online Jul 21, 2025. doi: 10.3748/wjg.v31.i27.107138
Figure 1
Figure 1  Regional prevalence of Helicobacter pylori (studies are highly variable in terms of diagnostic method use, setting and study population, and year of study).
Figure 2
Figure 2 Algorithm for empirical Helicobacter pylori eradication if individual antibiotic susceptibility testing is not available. 1High-dose proton pump inhibitor (PPI) or potassium-competitive acid blocker (vonoprazan where available) plus amoxicillin may be another option. 2Bismuth Quadruple Single Capsule[1]. Bismuth Quadruple Single Capsule: PPI; bismuth, tetracycline; and metronidazole. Clarithromycin triple: PPI; clarithromycin; and amoxicillin. It is only used if proven effective locally or if clarithromycin sensitivity is known. Non-bismuth quadruple (concomitant): PPI; clarithromycin; amoxicillin; and metronidazole. Levofloxacin quadruple: PPI; levofloxacin; amoxicillin; and bismuth. Levofloxacin triple: The same but without bismuth. In cases of high fluoroquinolone resistance (> 15%), the combination of bismuth with other antibiotics, high-dose PPI-amoxicillin dual, or rifabutin, may be an option. BQT: Bismuth quadruple therapy; HDDT: High dose dual therapy; P-CAB: Potassium-competitive acid blockers; PPI: Proton pump inhibitor.