Both ACG guidelines and World Gastroenterology Organisation (WGO) guidelines state that bismuth quadruple therapy consisting of a PPI, bismuth, tetracycline, and a nitroimidazole for 10-14 days is a recommended first-line treatment option. Bismuth quadruple therapy may be especially useful for patients with previous macrolide exposure, in those who are allergic to penicillin, and in regions of high clarithromycin resistance.
Triple therapy consisting of a PPI, clarithromycin, and amoxicillin or metronidazole remains a recommended treatment option only in regions where H pylori clarithromycin resistance is known to be less than 15% and in patients with no previous history of macrolide exposure for any reason. Fourteen days is the usual duration of therapy.
Learn more about the management of H pylori infection.
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Cite this: B.S. Anand, Steven F. Moss. Fast Five Quiz: Helicobacter pylori - Medscape - Jan 20, 2022.