TREATMENT REGIMENS
THREE DRUG REGIMENS |
| Proton pump inhibitor (PPI) orally twice daily + Clarithromycin 500mg orally twice daily + Amoxicillin 1gm orally twice daily [Available as Prevpac using PPI lansoprazole]. Eradication 85-90%. Duration 10-14 days* |
| Bismuth subsalicylate 525mg four times daily + Tetracycline 500mg four times daily + Metronidazole 500mg orally 3 to 4 times daily. Duration=14 days*. Cheapest option (about $15), but efficacy reduced without PPI. |
| Proton pump inhibitor orally twice daily + Clarithromycin 500mg orally twice daily + Metronidazole 500mg orally twice daily. Duration 10-14 days [for PCN allergic pts] |
| Ranitidine bismuth citrate 400mg orally twice daily + Clarithromycin 500mg orally twice daily + Amoxicillin 1gm orally twice daily Duration= 7-10 days |
| PPI orally twice daily + Amoxicillin 500mg orally twice daily-orally three times daily + Metronidazole 500mg orally 2 or 3 times daily x 10-14d |
| Ranitidine bismuth citrate 400mg orally twice daily + Clarithromycin 500mg orally twice daily + Metronidazole 500mg orally twice daily. Duration= 7 days |
| * denotes FDA approved regimens. PPI's = omeprazole 20mg, lansoprazole 30mg, pantoprazole 40mg, rabeprazole 20mg, esomeprazole 40mg ALL PO orally twice daily. |
| TWO DRUG REGIMENS (FDA APPROVED) |
| Dual therapy well-studied, but lower eradication rates (60-85%) make them second tier options. |
| PPI + either clarithromycin 500 mg orally three times daily OR Amox 1gm orally twice daily for 2 weeks then PPI for 2 more weeks (PPI = omeprazole 40mg QD or lansoprazole 30mg orally three times daily) |
| Ranitidine bismuth citrate (RBC) 400 mg orally twice daily + clarithromycin 500 mg orally three times daily OR orally twice daily for 2 weeks then RBC for 2 more weeks |
| FOUR DRUG REGIMEN |
| Proton pump inhibitor orally twice daily + Bismuth subsalicylate 525mg four times daily + Tetracycline 500mg four times daily + Metronidazole 500mg orally 3 to 4 times daily. Duration 2 weeks |
