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Indications forHelicobacter pylori eradication therapy and firstline therapy regimen in Japan: recommendation by the Japanese Society forHelicobacter Research

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Abstract

In November 2000, eradication therapy forHelicobacter pylori infection was approved under the present Japanese system of health insurance. Before the approval, the Japanese guideline of “Diagnosis and Treatment ofH. pylori infection” was made by the guideline committee of the Japanese Society forHelicobacter Research. Indications forH. pylori eradication therapy were classified into three groups: (A) recommended: gastric and duodenal ulcers; (B) recommended and managed at a specialized institution: low-grade gastric mucosa-associated lymphoid tissue lymphoma; (C) current studies of the significance of the therapy: following endoscopic mucosal resection of early gastric cancer and gastric surgery for gastric cancers, hyperplastic gastric polyp, atrophic gastritis, and nonulcer dyspepsia. The first-line therapy regimen recommended is 1 week of triple therapy with a proton pump inhibitor standard dose twice a day, amoxicillin 750mg bid, and clarithromycin 200 or 400mg bid. The reasons for preferring this regimen are to avoid extensive use of metronidazole, which is allowed for treatment ofTrichomonas infection in Japan, and the low rate of emergence of clarithromycin-resistantH. pylori with amoxicillin co-therapy. For second-line therapy patients should be referred to specialists, who can examine the susceptibility ofH. pylori isolates against antibiotics and have much experience with this therapy.

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  1. Department of Gastroenterology, Jichi Medical School, 3311-1 Yakushiji, Minami-Kawachi, Kawachi, 329-0498, Tochigi, Japan

    Kiichi Satoh

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Satoh, K. Indications forHelicobacter pylori eradication therapy and firstline therapy regimen in Japan: recommendation by the Japanese Society forHelicobacter Research. J Gastroenterol 37 (Suppl 13), 34–38 (2002). https://doi.org/10.1007/BF02990097

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