Eradicate Helicobacter pylori in older patients with quad or triple therapy

In most older patients with Helicobacter pylori infection, the risks of eradication therapy (ET) are outweighed by the benefits, which include decreases in the incidences of gastric cancer, ulcer-related bleeding, hospitalisation and death. ET involves proton pump inhibitors or potassium-competitive acid blockers, antibiotics and/or bismuth, with quadruple therapy as front-line therapy. Prescribing complexity is increased by age-related comorbidities and polypharmacy, but overall, ET is effective and well tolerated in older people. To ensure successful eradication and prevent the emergence of drug-resistant H. pylori, performing antibiotic-resistance testing, adhering to guideline-recommended treatment durations, switching antibiotics after treatment failure, and performing post-therapy examinations is recommended.