Sandbox/guillermo

Principles of Eradication Therapy for Helicobacter pylori infection

1. Indications for diagnosis and treatment, established (Chey and Wong):
   1. Active peptic ulcer disease.
   2. Confirmed history of peptic ulcer disease not previously treated for H. pylori.
   3. Gastric MALT lymphoma.
   4. After endoscopic resection of early gastric cancer.
   5. Uninvestigated dyspepsia (review H. pylori prevalence).
2. FDA approved first line regimens' duration:
   1. Triple therapy: 7 days (10 days if rabeprazole).
   2. Quadruple therapy: 4 weeks.

Helicobacter pylori Eradication Therapies

▸ Click on the following categories to expand treatment regimens.

First line   ▸  Triple therapy   ▸  Quadruple therapy Second line   ▸  Triple therapy   ▸  Sequential therapy   ▸  Hybrid therapy Third line therapy (Rescue therapy)   ▸  Rifabutin based

Triple therapy ▸ PPI standard dose PLUS ▸ Clarithromycin 500 mg q12h. PLUS ▸ Amoxicillin 1,0000 mg q12h Quadruple therapy ▸ Bismuth subsalicylate 525 mg orally q6h PLUS ▸ Metronidazol 250 mg orally q6h PLUS ▸ Tetracycline 500 mg orally q6h PLUS ▸ Ranitidine 150 mg orally q12h OR ▸ PPI standard dose Triple therapy ▸ PPI standard dose PLUS ▸ Clarithromycin 500 mg q12h PLUS ▸ Metronidazole 500 mg q12h Sequential therapy First 5 days ▸ PPI standard dose PLUS ▸ Amoxicillin 1,000 mg q12h Next 5 days ▸ PPI standard dose PLUS ▸ Clarithromycin 500 mg q12h PLUS ▸ Tinidazol 500 mg q12h Sequential therapy First 7 days ▸ PPI standard dose PLUS ▸ Amoxicillin 1,000 mg q12h Next 7 days ▸ PPI standard dose PLUS ▸ Amoxicillin 1,000 mg q12h PLUS ▸ Clarithromycin 500 mg q12h PLUS ▸ Metronidazol 500 mg q12h Third line treatment ▸ Rifabutin 150 mg q2h PLUS ▸ Amoxicillin 1,000 mg IV q12h PLUS ▸ Ciprofloxacin 500 mg/kg IV q12h