Abstract：
Helicobacter pylori infection is very common in the Spanish population and represents the main cause of chronic gastritis, peptic ulcer, and gastric cancer. The last iteration of Spanish consensus guidelines on H. pylori infection was conducted in 2016. Recent changes in therapeutic schemes along with increasing supporting evidence were key for developing the V Spanish Consensus Conference (May 2021). Fourteen experts performed a systematic review of the scientific evidence and developed a series of recommendations that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. An eradication therapy, when prescribed empirically, is considered acceptable when it reliably achieves, or preferably surpass, 90% cure rates. Currently, only quadruple therapies (with or without bismuth) and generally lasting 14 days, accomplish this goal in first- and second-line therapies. A non-bismuth quadruple concomitant regimen (proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole) or a quadruple bismuth-based combination (proton pump inhibitor, bismuth, tetracycline, and metronidazole), are recommended as first-line regimens. Rescue therapies after eradication failure and management of H. pylori infection in peptic ulcer disease were also reviewed.
摘要：
幽门螺杆菌感染在西班牙人群中非常常见，是慢性胃炎的主要原因，消化性溃疡,还有胃癌.西班牙关于幽门螺杆菌感染的共识指南的最后一次迭代是在2016年进行的。治疗方案的最新变化以及越来越多的支持证据是制定西班牙共识会议（2021年5月）的关键。14位专家对科学证据进行了系统的审查，并提出了一系列建议，这些建议经过了匿名的德尔菲迭代投票过程。使用GRADE指南对科学证据和建议的强度进行分类。根除疗法，当根据经验规定时，当它可靠地实现时，被认为是可以接受的，或者最好超过，90%治愈率。目前,只有四联疗法（含或不含铋），通常持续14天，在一线和二线治疗中实现这一目标。非铋四联伴随方案(质子泵抑制剂，克拉霉素,阿莫西林,和甲硝唑）或基于铋的四重组合（质子泵抑制剂，铋,四环素,和甲硝唑），被推荐为一线方案。还回顾了根除失败后的抢救治疗以及消化性溃疡疾病中幽门螺杆菌感染的管理。
