Sandbox MKK: Difference between revisions

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|BID
|BID
|14 days
|14 days
|
|YES(a)
|-
|-
|Bismuth Quadruple
|Bismuth Quadruple
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TID to QID (500mg)  
TID to QID (500mg)  
|10-14 days  
|10-14 days  
|
|NO
|-
|-
|Concomitant
|Concomitant
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|BID
|BID
|10 -14 days
|10 -14 days
|
|NO
|-
|-
|Sequential
|Sequential
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5-7 days  
5-7 days  
|
|NO
|-
|-
|Hybrid  
|Hybrid  
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|7 days
|7 days
7 days
7 days
|
|NO
|-
|-
|Levofloxacin triple  
|Levofloxacin triple  
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|10-14 days  
|10-14 days  
|
|NO
|-
|-
|Levofloxacin sequential
|Levofloxacin sequential
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BID
BID
|5-7 days
|5-7 days
|
|NO
|-
|-
|LOAD
|LOAD
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QD
QD
|7-10 days  
|7-10 days  
|
|NO
|}
|}



Revision as of 20:36, 26 October 2017

The ACG’s 2007 treatment guideline on the management of H. pylori infection (26) listed the following as established indications for diagnosis and treatment:

Active PUD (gastric or duodenal).

Confirmed history of PUD (not previously treated for H. pylori)

Gastric MALT lymphoma (low grade).

After endoscopic resection of EGC.

Recommenend first line treatment for Helicobacter pylori

Regimen Drug dose Dosing frequency Duration(days) FDA approval
Clarithromycin triple PPI(standard or double dose

Clarithromycin(500mg)

Amoxicillin(1gm)or Metronidazole(500mg TID)

BID 14 days YES(a)
Bismuth Quadruple PPI(standard dose)

Bismuth subcitrate (120-300mg)or Subsalicylate (300mg)

Tetracyclin(500mg)

Metronidazole(250-500mg)

BID

QID

QID

TID to QID (500mg)

10-14 days NO
Concomitant PPI (standard dose)

Clarithromycin (500mg)

Amoxicillin(1gm)

Nitroimidazole(500mg)

BID 10 -14 days NO
Sequential PPI(standard dose)+Amoxicillin(1gm)

PPI,Clarithromycin(500mg)+Nitroimidazole(500mg)

BID

BID

5-7 days

5-7 days

NO
Hybrid PPI(standard)+Amoxicillin(1gm)

PPI,Amoxicillin,Clarithromycin(500mg),Nitroimidazole(500mg)

BID

BID

7 days

7 days

NO
Levofloxacin triple PPI(standard dose)

Levofloxacin(500mg)

Amoxicillin(1gm)

BID

QID

BID

10-14 days NO
Levofloxacin sequential PPI(standard or double dose)+Amoxicillin(1 gm)

PPI,Amoxicillin,Levofloxacin(500mg QD),Nitroimidazole(500mg)

BID

BID

5-7 days NO
LOAD Levofloxacin(250mg)

PPI(double dose)

Nitazoxanide(500mg)

Doxycycline(100mg)

QD

QD

BID

QD

7-10 days NO

Adjuvant therapy in the treatment of H. pylori infection. Emerging evidence suggests an inhibitory effect of Lactobacillus and Bifidobacterium species on H. pylori. Furthermore, these probiotic strains may also help to reduce the side effects of eradication therapies and improve compliance with therapy.

Firstline Treatment

Selection of a first-line H. pylori treatment regimen:

 
 
 
 
 
 
 
 
•Is there a penicillin (PCN) allergy?
•Previous macrolide (MCL) exposure for any reason ?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•PCN allergy: No
•MCL exposure: No
 
 
•PCN allergy: No
•MCL exposure: Yes
 
•PCN allergy: Yes
•MCL exposure: No
 
•PCN allergy: Yes
•MCL exposure: Yes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Recomended treatment:
•Bismuth quadruple
•Clarithromycin triple with amoxicillin
•Other options:
•Sequential
•HYBRID
•Levofloxacin triple
•Levofloxacin sequential
•LOAD
 
 
Recomended treatment:
•Bismuth quadruple
•Levofloxacin sequential
•Other options:
•Concomitant therapy
•Sequential therapy
• HYBRID
•LOAD
 
Recomended treatment:
•Bismuth quadruple
•Clarithromycin triple
with metronidazole
•Bismuth quadruple
 
Recomended treatment:
•Bismuth quadruple
•Clarithromycin triple with metronidazole
•Bismuth quadruple