Which antibiotics for h pylori

So what are the best and most cost-effective treatments for H. Simply put, the ones that work, said Dr. While testing for antimicrobial sensitivity often guides treatment for other bacterial infections, it is not routinely available for H. Howden noted. Recent guidance provides some new direction. In , the American College of Gastroenterology published an updated clinical guideline for the treatment of H.

Howden, a coauthor of the guideline, outlined the two treatment regimens that internists should focus on when managing most of their patients. The first, bismuth-based quadruple therapy, includes bismuth, tetracycline, metronidazole, and a PPI for 10 to 14 days, but preferably 14 days, he said.

The second regimen, called concomitant therapy, involves clarithromycin, amoxicillin, metronidazole, and a PPI for 10 to 14 days again, preferably 14 days. Howden said. Howden said there are two key questions to consider when choosing a regimen for an individual patient:.

An additional consideration is the local antibiotic resistance pattern, although this information isn't always available, he noted. These samples are analyzed for H. This test is done to investigate symptoms that may be caused by other conditions such as gastric ulcer or gastritis that may be due to H.

The test may be repeated after treatment depending on what is found at the first endoscopy or if symptoms persist after H. At this second exam, biopsies can be performed to make sure H. This test isn't always recommended solely to diagnose an H. But it may be used to perform detailed testing for doctors to determine exactly which antibiotic to prescribe to treat H.

Your doctor also will prescribe or recommend an acid-suppressing drug, to help your stomach lining heal. Your doctor may recommend that you undergo testing for H. If the tests show the treatment was unsuccessful, you may undergo another round of treatment with a different combination of antibiotic medications.

See your primary care doctor if you have signs or symptoms that indicate a complication of H. Your doctor may test and treat you for H.

Because appointments can be brief, and because there's often a lot to discuss, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.

Before your appointment, you might want to write a list that answers the following questions:. Your time with your doctor is limited. Preparing a list of questions to ask may help you make the most of your time together. For H. San Diego: UpToDate; Sequential versus triple therapy for the first-line treatment of Helicobacter pylori: a multicenter, open-label, randomised trial. Sequential therapy for Helicobacter pylori eradication: the time is now!

Ther Adv Gastroenterol ;— Second-line treatment for Helicobacter pylori eradication after sequential therapy failure: a pilot study. Future Med ;— Second-line levofloxacin-based triple schemes for Helicobacter pylori eradication. Dig Liver Dis ;— Search PubMed Micomedix 2.

Adelaide: Pharmaceutical Society of Australia; Search PubMed. Back to search results. Also in this issue: Cardiology May Focus Cardiomyopathy. Anticoagulation: a GP primer on the new oral anticoagulants. Imaging for cardiac disease: a practical guide for general practitioners. Dizziness: if not vertigo could it be cardiac disease?

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Professional Increasing GP supervisor research skills — enhancing clinical practice and teaching. Back pages Book reviews. Clinical challenge. AJGP Biopsy specimen is combined with urea and pH is measured H.

Quick and inexpensive Highly sensitive and specific Not suitable for monitoring post-eradication because that would entail further gastroscopy. Expensive Not widely available Highly specific, low sensitivity. Inexpensive and widely available. Uses principle of urea metabolism by H. High positive predictive value High negative predictive value Suitable and recommended as the post-eradication monitoring test Not widely available. These medications are available to buy over the counter at pharmacies.

Your pharmacist can advise on which is most suitable for you. Antacids should be taken when you experience symptoms or when you expect them, such as after meals or at bedtime. You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol. If you're taking low-dose aspirin an NSAID to reduce your risk of blood clots , your GP will tell you whether you need to continue taking it.

If you do need to keep taking it, long-term treatment with a PPI or H2-receptor antagonist may be prescribed alongside the aspirin to try to prevent further ulcers. You're more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding.

Page last reviewed: 17 September Next review due: 17 September