Latest protocols for H. pylori drug treatment

  1.A triple combination regimen of three drugs is not recommended.  2.A quadruple therapy consisting of bismuth + PPI + 2 antibacterial drugs is recommended, such as the classic bismuth quadruple regimen (bismuth + PPI + tetracycline + metronidazole). The course of treatment is 14 days.  3.Bismuth is chosen as one of the following: bismuth potassium citrate (220mg, twice a day), colloidal bismuth (200mg, twice a day). Take them half an hour before meal.  4, PPI choose one of the following: omeprazole, pantoprazole, lansoprazole, rabeprazole, esomeprazole, eprazole. All twice a day, half an hour before meals 5, antibiotics in the choice of two of the six: commonly used amoxicillin + clarithromycin, amoxicillin + levofloxacin, amoxicillin + furazolidone, tetracycline ten metronidazole or furazolidone 6, amoxicillin, furazolidone and tetracycline resistance rate is still very low, treatment failure is not easy to produce resistance (can be repeated application); and clarithromycin, metronidazole and levofloxacin The resistance rate of clamoxyl, metronidazole and levofloxacin is high, and they are easy to develop resistance after treatment failure (in principle, they cannot be repeatedly applied).  7.Amoxicillin 1000mg/dose, twice a day, half an hour after meal; prior to negative penicillin skin test.  8.Clamoxyl 500mg/dose, twice a day, half an hour after meals; side effects: extremely bitter mouth.  9. Levofloxacin 500mg/dose, once a day, half an hour after meal or 200mg/dose, twice a day, half an hour after meal 10. Furazolidone 100mg/dose, twice a day, half an hour after meal 11. Tetracycline 750mg/dose, twice a day, half an hour after meal 12. Metronidazole 400mg/dose, twice or three times a day, half an hour after meal. Side effects: extremely bitter mouth.