title: IV Spanish Consensus Conference on Helicobacter pylori infection treatment.
abstract: Helicobacter pylori approximately infect 50% of Spanish population and causes chronic gastritis, peptic ulcer and gastric cancer. Until now, three consensus meetings on H.pylori infection had been performed in Spain (the last in 2012). The changes in the treatment schemes, and the increasing available evidence, have justified organizing the IVSpanish Consensus Conference (March 2016), focused on the treatment of this infection. Nineteen experts participated, who performed a systematic review of the scientific evidence and developed a series of recommendation that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. As starting point, this consensus increased the minimum acceptable efficacy of recommended treatments that should reach, or preferably surpass, the 90% cure rate when prescribed empirically. Therefore, only quadruple therapies (with or without bismuth), and generally lasting 14 days, are recommended both for first and second line treatments. Non-bismuth quadruple concomitant regimen, including a proton pump inhibitor, clarithromycin, amoxicillin and metronidazole, is recommended as first line. In the present consensus, other first line alternatives and rescue treatments are also reviewed and recommended.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España. Electronic address: javier.p.gisbert@gmail.com.
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.affiliation: Servicio de Aparato Digestivo, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Molina-Infante
authors.affiliation: Medicina de Familia, Centro de Salud Los Ángeles, Madrid, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Amador
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bermejo
authors.affiliation: Servicio de Digestivo, Hospital Donostia/Instituto Biodonostia, Universidad del País Vasco UPV/EHU, CIBEREHD, San Sebastián, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.affiliation: Servicio de Aparato Digestivo, Hospital Parc Taulí, Universitat Autónoma de Barcelona, CIBEREHD, Sabadell, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de Valme, CIBEREHD, Sevilla, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Castro-Fernández
authors.affiliation: Servicio Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cuadrado-Lavín
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínic, CIBEREHD, Barcelona, España.
authors.forename: J Ignasi
authors.initials: JI
authors.lastname: Elizalde
authors.affiliation: Servicio de Urgencias, Hospital Parc Taulí Sabadell, CIBEREHD, Universitat Internacional de Catalunya, Sabadell, Barcelona, España.
authors.forename: Emili
authors.initials: E
authors.lastname: Gene
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, IIS Aragón, CIBEREHD, Zaragoza, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomollón
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, IIS Aragón, CIBEREHD, Zaragoza, España.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Lanas
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martín de Argila
authors.affiliation: Servicio de Aparato Digestivo, Centro Médico Teknon, Barcelona, España.
authors.forename: Fermín
authors.initials: F
authors.lastname: Mearin
authors.affiliation: Servicio de Aparato Digestivo, Hospital San Jorge, Huesca, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Montoro
authors.affiliation: Servicio de Aparato Digestivo, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España.
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Pérez-Aisa
authors.affiliation: Servicio de Microbiología, Hospital Donostia/Instituto Biodonostia, Universidad del País Vasco UPV/EHU, CIBEREHD, San Sebastián, España.
authors.forename: Emilio
authors.initials: E
authors.lastname: Pérez-Trallero
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España.
authors.forename: Adrián G
authors.initials: AG
authors.lastname: McNicholl
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003697:Delphi Technique; D004359:Drug Therapy, Combination; D005756:Gastritis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D015201:Meta-Analysis as Topic; D019936:Probiotics; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000209:etiology / Q000517:prevention & control; D013276:Stomach Ulcer / Q000209:etiology / Q000517:prevention & control; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D001729:Bismuth
keywords: Bismuth; Bismuto; Clarithromycin; Claritromicina; Helicobacter pylori; Inhibidor de la bomba de protones; Metronidazol; Metronidazole; Omeprazol; Omeprazole; Proton pump inhibitor