Management of Helicobacter pylori infection is evolving. New data concern the 
role of the bacterium in various clinical conditions, the indications of H. 
pylori testing, diagnosis procedures and eradication treatment regimens. H. 
pylori should be sought and eradicated before starting NSAIDs treatment, in 
aspirin users with a history of gastroduodenal ulcer, and in patients presenting 
with chronic dyspepsia, high risk factors of gastric cancer, unexplained iron 
deficiency anaemia, vitamin B12 deficiency, or immune (idiopathic) 
thrombocytopenic purpura. The Urea Breath Test remains the best test to diagnose 
H. pylori infection, whereas serology is the only test, which is not affected by 
local changes in the stomach. Molecular tests can be used to detect H. pylori 
and clarithromycin and/or fluoroquinolone resistance in gastric biopsies without 
necessitating culture. In regions of high clarithromycin resistance, such as 
France, sequential treatment or bismuth-containing quadruple therapies are 
replacing standard triple therapies for the first-line empirical treatment.