title: Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children.
abstract: OBJECTIVE
  As the clinical implications of Helicobacter pylori infection in children and adolescents continue to evolve, ESPGHAN and NASPGHAN jointly renewed clinical guidelines using a standardized evidence-based approach to develop updated recommendations for children and adolescents in North America and Europe.
  
  
  METHODS
  An international panel of 11 pediatric gastroenterologists, 2 epidemiologists, 1 microbiologist, and 1 pathologist was selected by societies that developed evidence-based guidelines based on the Delphi process with anonymous voting in a final face-to-face meeting. A systematic literature search was performed on 8 databases of relevance including publications from January 2000 to December 2009. After excluding nonrelevant publications, tables of evidence were constructed for different focus areas according to the Oxford classification. Statements and recommendations were formulated in the following areas: whom to test, how to test, whom to treat, and how to treat. Grades of evidence were assigned to each recommendation based on the GRADE system.
  
  
  RESULTS
  A total of 2290 publications were identified, from which 738 were finally reviewed. A total of 21 recommendations were generated, and an algorithm was proposed by the joint committee providing evidence-based guidelines on the diagnostic workup and treatment of children with H pylori infection.
  
  
  CONCLUSIONS
  These clinical practice guidelines represent updated, best-available evidence and are meant for children and adolescents living in Europe and North America, but they may not apply to those living on other continents, particularly in developing countries with a high H pylori infection rate and limited health care resources.
authors.affiliation: Dr von Haunersches Kinderspital, Ludwig-Maximilians-University of Munich, Munich, Germany. sibylle.koletzko@med.uni-muenchen.de
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.forename: Nicola L
authors.initials: NL
authors.lastname: Jones
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Goodman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gold
authors.forename: Marion
authors.initials: M
authors.lastname: Rowland
authors.forename: Samy
authors.initials: S
authors.lastname: Cadranel
authors.forename: Sonny
authors.initials: S
authors.lastname: Chong
authors.forename: Richard B
authors.initials: RB
authors.lastname: Colletti
authors.forename: Thomas
authors.initials: T
authors.lastname: Casswall
authors.forename: Yoram
authors.initials: Y
authors.lastname: Elitsur
authors.forename: Jeannette
authors.initials: J
authors.lastname: Guarner
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kalach
authors.forename: Armando
authors.initials: A
authors.lastname: Madrazo
authors.forename: Francis
authors.initials: F
authors.lastname: Megraud
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Oderda
mesh_terms: D000293:Adolescent; D000328:Adult; D000863:Antacids / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D003663:Decision Trees; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D005060:Europe; D019317:Evidence-Based Medicine; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009656:North America; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000863:Antacids; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D017291:Clarithromycin