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%. Regarding the question of which groups of people should be tested for Hp infection, the recommendations of domestic and foreign experts’ consensus are not entirely consistent. Under what circumstances should HP be eradicated, how to choose the optimal treatment program and how to cope with the failure of eradication? How to use antibiotics correctly and how to deal with H. pylori positivity on physical examination? All these questions are difficult for clinicians! When to eradicate HP? 1, peptic ulcer: the most important indication for Hp eradication. Eradication of Hp leads to complete healing of chronic and recurrent diseases. 2, Hp-positive chronic gastritis with dyspepsia: eradication of Hp can make 8%~20% of Hp-positive functional dyspepsia. of Hp-positive functional dyspepsia (FD) patients get long-term relief of symptoms, and the efficacy is better than any other treatment. Compared with the immediate endoscopic results of treatment, the “detection and eradication of Hp treatment strategy” obtains the same rate of symptomatic relief, reduces the patient’s diagnostic examination, and thus reduces the medical cost. Chronic gastritis with gastric mucosal atrophy or erosion. Family history of gastric cancer: except for a small number of hereditary diffuse gastric cancer (about 1%~3%), the occurrence of the vast majority of gastric cancer is the result of Hp infection, environmental factors and genetic factors. The genetic susceptibility of first-degree relatives of gastric cancer patients is high. Although it is difficult to change the genetic susceptibility, eradication of Hp can eliminate the important factors for the development of gastric cancer, thus improving the preventive effect. 5. Individual request for treatment: those who are <45 years old and have no alarm symptoms support eradication of Hp. Before treatment, the potential risks of this treatment strategy should be clearly explained to the recipients, including missed detection of upper gastrointestinal tract tumors, masking of the disease, and adverse reactions to medications, etc. Those who are >45 years old or have alarm symptoms need to be examined by endoscopy first. How to choose the best treatment plan? 1, Program: preferred bismuth-containing quadruple. 2.Stop taking PPI for not less than 2 weeks and stop taking antibiotics and bismuth agent for not less than 4 weeks before eradication treatment. 3.Remedial treatment is recommended at an interval of 2~3 months. 4.Retreatment after two failures: reassessment + drug sensitivity. Eradication of HP, you must understand these! 1, the choice of antimicrobial drugs on the impact of Hp eradication treatment: the initial treatment or retreatment with the choice of antimicrobial drugs that have become resistant to Hp is one of the major causes of eradication failure. Any kind of antimicrobial drugs used alone is difficult to achieve eradication effect, and easy to make Hp secondary drug resistance, so the treatment of Hp infection must be taken as a combination of therapeutic programs.PPI, bismuth and antimicrobial drugs can not only reduce the production of drug-resistant strains of Hp, but also increase the activity of the antibacterial drug and antibacterial drugs in the stomach concentration of the drug, so as to improve the efficacy of the eradication of Hp. If patients choose the combination of amoxicillin and clarithromycin in the first treatment, the eradication rate of the second eradication treatment after treatment failure is higher than that of the combination containing metronidazole in the first treatment. 2, the course of treatment on the impact of Hp eradication treatment: in the choice of standard Hp eradication treatment program, the course of treatment is also insufficient to lead to one of the reasons for treatment failure. Sufficient or appropriate prolongation of the course of treatment can not only improve the rate of Hp eradication, but also reduce the emergence of Hp resistance to antimicrobial drugs. 3, adverse drug reactions to the impact of eradication therapy: such as patients allergic to drugs or intolerance, so that patients are forced to stop the drug, can not complete the treatment, but also lead to the failure of Hp eradication therapy is one of the important reasons.