Hp is one of the bacteria with the highest rate of infection in the world’s population, and the rate of Hp infection in China is about 60%. The recommendations of domestic and international expert consensus on which populations should be tested for Hp infection are not entirely consistent. Under what circumstances should HP be eradicated, how to choose the optimal treatment plan, and what to do if eradication fails? What is the proper use of antibiotics and how to deal with a positive H. pylori finding on physical examination? These are the questions that clinicians face! When to eradicate HP 1. Peptic ulcer is the most important indication for HP eradication. Hp eradication makes chronic, recurrent disease completely cured. 2. Gastric MALT lymphoma (rare gastric malignancy) is about 80% or more Hp positive, and complete response can be obtained after early Hp eradication. Hp eradication has become the first-line treatment for early gastric MALT lymphoma. 3, Hp-positive chronic gastritis with dyspepsia Hp eradication can provide long-term relief of symptoms in 8% to 20% of patients with Hp-positive functional dyspepsia (FD), and the efficacy is better than any other treatment. Compared with immediate endoscopic treatment, the “strategy of detecting and eradicating Hp treatment” achieves the same symptom relief rate and reduces the diagnostic tests for patients, thus reducing medical costs. 4.Chronic gastritis with gastric mucosal atrophy or erosion 5.Family history of gastric cancer Except for a small number (about 1%~3%) of hereditary diffuse gastric cancer, the occurrence of most gastric cancers is the result of the combination of Hp infection, environmental factors and genetic factors. The genetic susceptibility of first-degree relatives of gastric cancer patients is high. Although genetic susceptibility is difficult to change, eradication of Hp can eliminate important factors in the development of gastric cancer, thus improving the prevention effect.6. Individuals who require treatment at age <45 years and without alarm symptoms support eradication of Hp. The potential risks of this treatment strategy, including missed detection of upper gastrointestinal tumors, masking of the disease and adverse drug reactions, need to be clearly explained to the treated patients before treatment. The risk of gastroduodenal ulcer is increased in patients with Hp infection, NSAIDs and/or low-dose aspirin; in patients taking NSAIDs and/or low-dose aspirin for a long time, the risk of gastroduodenal ulcer is increased. Hp eradication before long-term use of NSAIDs and/or low-dose aspirin reduces the risk of gastroduodenal ulcers in those taking these drugs. However, Hp eradication alone does not reduce the incidence of gastroduodenal ulcers in patients already on long-term therapy, who require continuous PPI maintenance in addition to Hp eradication.