For peptic ulcers caused by H. pylori infection, eradication of H. pylori can not only promote ulcer healing, but also prevent ulcer recurrence and thus completely cure the ulcer. Therefore, all peptic ulcers with H. pylori infection should be treated with eradication of H. pylori, regardless of whether it is initial or recurrent, active or quiescent, with or without comorbidities. 1, eradication of Helicobacter pylori treatment program has been proved in vivo with the effect of killing H. pylori antibiotics are clarithromycin, amoxicillin, metronidazole (or tinidazole), tetracycline, furazolidone, some quinolones such as levofloxacin, etc. PPI and colloidal bismuth in vivo can inhibit H. pylori, and the above antibiotics have a synergistic bactericidal effect. There is no single drug that can effectively eradicate H. pylori, so a combination of drugs must be used. A treatment plan with a high eradication rate of H. pylori should be chosen to achieve a successful eradication. Studies have shown that a triple therapy regimen based on PPI or colloidal bismuth plus two antibiotics has a high eradication rate. Among these regimens, PPI-based regimens contain PPI that can improve the antibacterial activity of oral antibiotics by inhibiting gastric acid secretion, thus increasing the eradication rate, and PPI itself has rapid symptom relief and promotes ulcer healing; therefore, it is the most commonly used regimen in clinical practice. Among them, PPI plus clarithromycin plus amoxicillin or metronidazole has the highest eradication rate. The main reasons for H. pylori eradication failure are patient compliance and resistance of H. pylori to antibiotics in the treatment regimen. Therefore, when choosing a treatment regimen, it is important to understand the drug resistance in your region. In recent years, the rate of H. pylori resistance to metronidazole and clarithromycin has been increasing in many countries around the world and in some regions of China, which should be noted. Furazolidone (200mg/d in 2 doses) resistance is rare and inexpensive, and triple therapy with furazolidone instead of clarithromycin or metronidazole has been reported in China to achieve a high eradication rate, but attention should be paid to the adverse effects caused by furazolidone such as peripheral neuritis and hemolytic anemia. After treatment failure, it is more difficult to re-treat the disease, and can be replaced with two other antibiotics (primary and secondary resistance to amoxicillin are rare and can be left out) such as PPI plus levofloxacin (500mg/d, once a day) and amoxicillin, or quadruple therapy with PPI and colloidal bismuth combined with tetracycline (1500mg/d, twice a day) and metronidazole. 2, anti-ulcer therapy after the end of H. pylori eradication treatment after the end of H. pylori eradication course, continue to give a conventional course of anti-ulcer therapy (such as DU patients given PPI conventional dose, once a day, the total course of 2-4 weeks, or H↓2RA conventional dose, the course of 4-6 weeks; GU patients PP1 conventional dose, once a day, the total course of 4-6 weeks, or H↓2RA conventional dose, the course of 6-8 weeks). dose, duration of treatment 6 to 8 weeks) is ideal. This is especially necessary in patients with complications or large ulcers, but for those without complications and with complete symptom relief at the end of eradication therapy, discontinuation may also be considered to save on drug costs. 3, review after H. pylori eradication treatment After treatment, H. pylori should be routinely reviewed to see if it has been eradicated. The review should be done at least 4 weeks after the end of H. pylori eradication treatment, and PPI or bismuth should be discontinued for 2 weeks before the examination, otherwise false negatives will occur. A non-invasive ↑(13)C or ↑(14)C urea breath test can be used, or a biopsy for urease and/or histology can be taken by gastroscopy while examining whether the ulcer is healing. Gastroscopic review should be routinely performed for peptic ulcers where malignant gastric ulcers or complications have not been ruled out.