( ) infection is associated with various gastric and extra-gastric diseases. Importantly, this infection is the strongest known risk factor for gastric cancer (GC). eradication can effectively prevent infection-associated diseases in -positive patients, including children and elderly subjects. However, a limited selection of antibiotics, a higher reinfection rate, and certain spontaneous clearance rates, to some extent, restrict the choice of treatments in pediatrics. In addition, it is imperative to perform an accurate diagnosis of infection in children by determining the presence of the infection and the underlying cause of symptoms. In elderly patients, poor tolerance to drugs and higher sensitivity to adverse effects are major concerns during therapy. Recent studies have demonstrated that eradication could significantly lower the GC risk in the elderly population. The benefit and risk of eradication in elderly patients should be comprehensively considered and balanced. If available, susceptibility-based tailored therapies may be preferable in eradicating . In addition, to increase the eradication rate and reduce adverse effects, new therapeutic strategies (e.g., probiotic supplementation, berberine supplementation, dual therapy) for infection are being extensively investigated. The impact of eradication with antibiotics on the microbiota in children has been explored, but further high-quality studies are crucial to delineate the extent of eradication affecting the microbial community in children. In this review, we summarize the current understanding of diagnosis and treatment in children and the elderly population and aim to provide insights into the efficient management and treatment implementation in these populations.
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