Indications for screening for Helicobacter pylori
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In countries with a low prevalence of Hp infection (Europe, Canada, United States), population-based screening is not recommended.
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It is recommended that patients under 45 years of age with no family history of gastric cancer and symptoms of dyspepsia without warning signs such as anemia, weight loss, dysphagia, palpable mass, and malabsorption be screened in primary care.
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Screening and diagnostic methods: non-invasive tests |
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Treatment modalities and knowledge of primary care physicians |
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The last decade was characterized by a marked decline in the success of triple therapy due to the emergence of resistance to clarithromycin
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In the absence of antibiotic susceptibility studies, treatment with concomitant quadruple therapy is recommended as first-line therapy, combining a PPI, amoxicillin, clarithromycin, and metronidazole for 14 days.
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In case of previous use of macrolide or allergy to amoxicillin, a quadruple therapy with bismuth for 10 days is preferred, combining omeprazole with a bismuth salt, tetracycline, and metronidazole.
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