Current progress toward eradicating Helicobacter pylori in East Asian countries: Differences in the 2013 revised guidelines between China, Japan, and South Korea

Table 4 Different characteristics of 2013 guidelines in three countries

	Country	Notable differences in characteristics
Indication for eradication	China	Strong recommendations do not include after resection of EGC. Intestinal metaplasia is not included in the indications
	Japan	All infected subjects are included as “H. pylori-related gastritis”
		Focus is on preventing dissemination
	South Korea	Strong recommendations include only peptic ulcer disease, gastric MALT lymphoma, and after resection of EGC
Diagnostic method	China	Serology is not recommended
		Only the urea breath test is recommended after eradication
		Invasive tests are not recommended after eradication
	Japan	Either two noninvasive tests or one invasive test is recommended
		A decrease relative to the initial serum antibody level of more than 50% after 6-12 mo is considered the most reliable method
	South Korea	Bacterial culture is not included
Treatment regimen	China	Due to the high resistance to the antibiotics metronidazole, clarithromycin, and tetracycline, an alternative regimen is recommended
		First-line treatment can be omitted in cases of clarithromycin resistance
	Japan	Lower dose of antibiotics for shorter duration (7 d) than other countries
		There is neither 14 d nor bismuth-based regimen in the first-line and second-line treatment
	South Korea	First-line treatment can be omitted in cases of clarithromycin resistance

EGC: Early gastric cancer; H. pylori: Helicobacter pylori; MALT: Mucosa-associated lymphoid tissue.