Fast Five Quiz: Management of Helicobacter pylori

Steven F. Moss, MD


January 25, 2022

In clinical practice, first-line therapy generally offers the best likelihood of treatment success. Careful attention to the selection of the optimal first-line eradication therapy for an individual patient is therefore crucial.

ACG guidelines suggest hybrid therapy consisting of a proton pump inhibitor (PPI) and amoxicillin for 7 days followed by a PPI, amoxicillin, clarithromycin, and a nitroimidazole for 7 days as a possible first-line treatment option. However, hybrid therapy is not endorsed by World Gastroenterology Organisation guidelines.

Similar to hybrid therapy, sequential therapy comprising a PPI and amoxicillin for 5-7 days followed by a PPI, clarithromycin, and a nitroimidazole for 5-7 days is endorsed by the ACG as a possible first-line choice but is not supported by the World Gastroenterology Organisation.

Previous macrolide exposure is a significant consideration when selecting a first-line treatment regimen for patients with H pylori infection due to concerns about antibiotic resistance.

Learn more about the management of H pylori infection.


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