Copyright ©The Author(s) 2016.
World J Gastroenterol. Jan 21, 2016; 22(3): 1311-1320
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1311
Table 1 Recommended first and second line Helicobacter pylori eradication regimen
1st line regimen2nd line regimen
Japan[15]PPI, amoxicillin 750 mg, clarithromycin 200 mg to 400 mg twice dailyPPI, amoxicillin 750 mg, metronidazole 250 mg twice daily
Duration: 7 dDuration: 7 d
Korea[14]PPI, amoxicillin 1 g, clarithromycin 500 mg twice dailyPPI, bismuth 120 mg four times daily, tetracycline 500 mg four times daily, metronidazole 500 mg three times daily
Duration: 7-14 dDuration: 7-14 d
Europe[16]PPI-clarithromycin containing triple therapy ORBismuth-containing quadruple therapy OR levofloxacin-containing triple
Bismuth or non-bismuth containing quadruple1
Duration: 7-14 dDuration: 10 d
China[13]No preferential choice. Options include: (1)PPI, amoxicillin 1 g, clarithromycin 500 mg twice daily (2) PPI, amoxicillin 1 g, levofloxacin 200 mg twice daily (or levofloxacin 500 mg daily) (3) PPI, amoxicillin 1 g, furazolidone 100 mg twice daily (4) PPI, tetracycline 750 mg, metronidazole 400 mg twice daily (or metronidazole 400 mg three times per day) (5) PPI, bismuth 220 mg plus any of the two antibiotics above twice daily
Duration: 7-14 d
Table 2 Operative Link for Gastritis Assessment[31]
No atrophy (score 0)Mild atrophy (score 1)Moderate atrophy (score 2)Severe atrophy (score 3)
Antrum (including incisura angularis)
No atrophy (score 0)Stage 0Stage IStage IIStage II
Mild atrophy (score 1)Stage IStage IStage IIStage III
Moderate atrophy (score 2)Stage IIStage IIStage IIIStage IV
Severe atrophy (score 3)Stage IIIStage IIIStage IVStage IV
Table 3 Pharmacological treatment of gastric intestinal metaplasia
Ref.InterventionStudy designCountriesNumber of patientsResults
Kong et al[38], 2014H. pylori eradicationMeta-analysis of 16 trials (including 1 RCT and 15 observational studies)China, Japan, Italy and Columbia3432Antral IM: pooled WMD with 95%CI: 0.23 (0.18-0.29)
Corpus IM: pooled WMD with 95%CI: -0.01 (-0.04-0.02)
Leung et al[42], 2006Rofecoxib for 24 moRCT (vs placebo)China213 after H. pylori eradicationAntrum IM regression: 24.5% vs 26.9% in placebo
Corpus IM regression 4.3% vs 2.2% in placebo
Wong et al[43], 2012Celecoxib for 24 moRCT (H. pylori eradication, celecoxib or both)China1024 H. pylori positiveOR for regression of gastric lesions 1.72 (95%CI: 1.07-2.76)
You et al[44], 2006Vitamins or Anti-oxidantsRCT (H. pylori eradication, vitamins or garlic supplements)China3365Both vitamins and garlic supplements have no effect on gastric precancerous lesion