Fast Five Quiz: Helicobacter pylori

B.S. Anand, MD; Steven F. Moss, MD


January 20, 2022

Most patients who give a history of penicillin allergy are not truly allergic to beta-lactam antibiotics. After negative allergy testing, amoxicillin can safely be given in H pylori eradication regimens.

First-line regimens should not be repeated in the second-line treatment of H pylori. Second-line regimens should also incorporate at least one different antibiotic.

A combination of sequential and concomitant therapy (hybrid therapy) has been shown to result in high eradication rates in some populations.

Additional treatments for H pylori are under investigation. One such agent is vonoprazan (VPZ), a potent new acid-inhibitory drug. In a systematic review with meta-analysis, VPZ-based triple therapy was shown to have superior efficacy for second-line H pylori eradication compared with PPI-based triple therapy; this may be due to VPZ's strong and homogeneous acid suppression effect. High-dose dual therapy using a combination of amoxicillin and a PPI for 14 days is another promising approach that has shown good success rates and tolerability in clinical trials.

Learn more about H pylori treatment regimens.

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