Current guidelines for Helicobacter pylori treatment in East Asia 2022: Differences among China, Japan, and South Korea

Table 1 Recommended regimens according to the Helicobacter pylori treatment guidelines in China, Japan, and South Korea

Country	Regimen		Drugs	Duration (d)
China	1		PPI bid + bismuth 220 mg bid + AMX 1000 mg bid + CAM 500 mg bid	14
	2		PPI bid + bismuth 220 mg bid + AMX 1000 mg bid + MDZ 400 mg tid or qid	14
	3		PPI bid + bismuth 220 mg bid + AMX 1000 mg bid + LVFX 500 mg qd or 200 mg bid	14
	4		PPI bid + bismuth 220 mg bid + AMX 1000 mg bid + FZD 100 mg bid or tid	14
	5		PPI bid + bismuth 220 mg bid + AMX 1000 mg bid + TET 500 mg tid or qid	14
	6		PPI bid + bismuth 220 mg bid + MDZ 400 mg tid or qid + TET 500 mg tid or qid	14
	7		PPI bid + bismuth 220 mg bid + FZD 100 mg bid + TET 500 mg tid or qid	14
Japan	First-line		PPI or vonoprazan 20 mg bid + AMX 750 mg bid + CAM 200 mg bid	7
	Second-line		PPI bid + AMX 750 mg bid + MDZ 250 mg bid	7
	Third-line		PPI bid + AMX 750 mg or MDZ 250 mg bid + STFX 100 mg bid	7
South Korea	First-line	Standard triple therapy	PPI bid + AMX 1000 mg bid + CAM 500 mg bid	14
		Sequential therapy	PPI bid + AMX 1000 mg bid (5 d), then CAM 500 mg bid + MDZ 500 mg bid (5 d)	10
		Concomitant therapy	PPI bid + AMX 1000 mg bid + CAM 500 mg bid + MDZ 500 mg bid	10
		Tailored therapy	Standard triple therapy (CAM-sensitive) or classic BQT (CAM-resistant)	7-14
	Second-line	Classic BQT	PPI bid + bismuth 120 mg qid + MDZ 500 mg tid + TET 500 mg qid	10-14
	Third-line	-	PPI bid + AMX 1000 mg bid + LVFX 500 mg qd or 250 mg bid	10-14

AMX: Amoxicillin; BQT: Bismuth quadruple therapy; CAM: Clarithromycin; FZD: Furazolidone; LVFX: Levofloxacin; MDZ: Metronidazole; PPI: Proton pump inhibitor; STFX: Sitafloxacin; TET: Tetracycline.