Practice Tips From the Updated Helicobacter pylori Treatment Guidelines

In 2024, the American College of Gastroenterology released updated guidelines for managing Helicobacter pylori infection, replacing the previous 2017 guidelines. Since that time, 3 new first-line treatment options have been approved in the United States and knowledge of rising antimicrobial resistance (now above 30% for clarithromycin, levofloxacin, and metronidazole) has been accumulating. Key clinical updates in the 2024 guidelines include new recommendations on screening practices, selecting the most appropriate treatment regimens for initial H pylori infection, and using antimicrobial susceptibility testing in cases where the infection does not respond to initial therapy. This article summarizes these updates with an emphasis on how the current guidelines differ from the previous version. The aim of this article is to present this information in a digestible manner for practicing gastroenterologists and other clinicians who treat patients with H pylori infection.