University of Oklahoma Health Sciences Center

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Author/s:

Hannah C. Matthews, Jason T. Alexander

Date Added:

March 20, 2026

Journal/Publication:

Journal of the American Medical Association

Publisher:

American Medical Association

Publication Date:

March 18, 2026

URL:

JAMA Treatment of Helicobacter pylori Infection

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

doi: 10.1001/jama.2026.0663

Keywords

Infection

Helicobacter pylori

MeSH

Helicobacter Infections

Helicobacter pylori

Gastroenterology

RPR Commentary

A guideline for management of patients with H. Pylori infections from the American College of Gastroenterology. James W. Mold, MD, MPH

Abstract

Guideline title ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Release date September 2024

Prior version 2017

Developer American College of Gastroenterology (ACG)

Target population Outpatients aged 18 years or older with H pylori infection, with recommendations prioritized for persons residing in North America

Selected recommendations

For treatment-naive patients with H pylori infection, bismuth quadruple therapy (BQT) for 14 days is recommended as first-line treatment (strong recommendation; moderate quality of evidence [QOE]). When BQT is not an option, rifabutin triple therapy (conditional recommendation; low QOE) or potassium-competitive acid blocker (PCAB; eg, vonoprazan) dual therapy (conditional recommendation; moderate QOE) are suggested.

For treatment-naive patients with H pylori, empirical use of regimens containing clarithromycin is not recommended. However, if no first-line treatment is available, PCAB triple therapy is suggested over proton pump inhibitor (PPI) triple therapy (conditional recommendation; moderate QOE).

For patients with persistent H pylori infection who received PPI triple therapy rather than BQT, BQT is suggested (conditional recommendation; low QOE).

For patients with persistent H pylori infection who have received BQT, rifabutin triple therapy is suggested (conditional recommendation; low QOE).

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