Fast Five Quiz: Management of Helicobacter pylori

Steven F. Moss, MD; Cristian Puerta, MD


October 18, 2023

Multiple meta-analyses have shown that eradication rates with 7 or 10 days of clarithromycin-based triple therapy are < 80%. In a global meta-analysis performed by the Cochrane Collaboration, increased duration of triple therapy (14 days vs 7 days) led to higher eradication rates (81.9% vs 72.9%, respectively) regardless of type and dose of antibiotic. A treatment duration of any H pylori therapy, especially refractory infection, for 14 days has demonstrated better outcomes than treatment duration lasting 7-10 days.

In regions where clarithromycin resistance is > 15%, clarithromycin-based triple therapy should be avoided. However, in regions where clarithromycin resistance is known to be low, triple therapy consisting of a PPI, clarithromycin, and amoxicillin or metronidazole remains a first-line treatment option.

Learn more about treatment options for H pylori infection.


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