Guidelines for the salvage therapy: Difference between revisions

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==2017 ACG Guidelines for first-line treatment strategies of peptic ulcer disease for providers in North America==
{| class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen" |Strong recommendation
|-
| bgcolor="LightGreen" |1.Bismuth quadruple therapy consisting of a PPI, bismuth, tetracycline, and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option.
Bismuth quadruple therapy is particularly attractive in patients with any previous macrolide exposure or who are allergic to penicillin
|-
| bgcolor="LightGreen" |2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
|-
|-
| bgcolor="LightGreen" |2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
|-
|-
| bgcolor="LightGreen" |2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
|-
|-
| bgcolor="LightGreen" |2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
|-
|}
{| class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon" |Conditional recommendation
|-
| bgcolor="LemonChiffon" |'''1.'''Patients should be asked about any previous antibiotic exposure(s) and this information should be taken into consideration when choosing an H. pylori
treatment regimen '''.'''
|-
| bgcolor="LemonChiffon" |2.Clarithromycin triple therapy consisting of a PPI, clarithromycin, and amoxicillin or metronidazole for 14 days remains a recommended treatment in regions
where H. pylori clarithromycin resistance is known to be <15% and in patients with no previous history of macrolide exposure for any reason.
|-
| bgcolor="LemonChiffon" |3.Sequential therapy consisting of a PPI and amoxicillin for 5–7 days followed by a PPI, clarithromycin, and a nitroimidazole for 5–7 days is a suggested first line
treatment option.
|-
|-
| bgcolor="LemonChiffon" |4.Hybrid therapy consisting of a PPI and amoxicillin for 7 days followed by a PPI, amoxicillin, clarithromycin and a nitroimidazole for 7 days is a suggested
first-line treatment option.
|-
| bgcolor="LemonChiffon" |5.Levofloxacin triple therapy consisting of a PPI, levofloxacin, and amoxicillin for 10–14 days is a suggested first-line treatment option.
|-
| bgcolor="LemonChiffon" |6.Fluoroquinolone sequential therapy consisting of a PPI and amoxicillin for 5–7 days followed by a PPI, fluoroquinolone, and nitroimidazole for 5–7 days is a
suggested first-line treatment option.
|}

Revision as of 19:56, 1 December 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2], Sargun Singh Walia M.B.B.S.[3]

2017 ACG Guidelines for first-line treatment strategies of peptic ulcer disease for providers in North America

Strong recommendation
1.Bismuth quadruple therapy consisting of a PPI, bismuth, tetracycline, and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option.

Bismuth quadruple therapy is particularly attractive in patients with any previous macrolide exposure or who are allergic to penicillin

2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option
2.Concomitant therapy consisting of a PPI, clarithromycin, amoxicillin and a nitroimidazole for 10–14 days is a recommended fi rst-line treatment option


Conditional recommendation
1.Patients should be asked about any previous antibiotic exposure(s) and this information should be taken into consideration when choosing an H. pylori

treatment regimen .

2.Clarithromycin triple therapy consisting of a PPI, clarithromycin, and amoxicillin or metronidazole for 14 days remains a recommended treatment in regions

where H. pylori clarithromycin resistance is known to be <15% and in patients with no previous history of macrolide exposure for any reason.

3.Sequential therapy consisting of a PPI and amoxicillin for 5–7 days followed by a PPI, clarithromycin, and a nitroimidazole for 5–7 days is a suggested first line

treatment option.

4.Hybrid therapy consisting of a PPI and amoxicillin for 7 days followed by a PPI, amoxicillin, clarithromycin and a nitroimidazole for 7 days is a suggested

first-line treatment option.

5.Levofloxacin triple therapy consisting of a PPI, levofloxacin, and amoxicillin for 10–14 days is a suggested first-line treatment option.
6.Fluoroquinolone sequential therapy consisting of a PPI and amoxicillin for 5–7 days followed by a PPI, fluoroquinolone, and nitroimidazole for 5–7 days is a

suggested first-line treatment option.

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