Effective Helicobacter pylori regimens available in the United States
| Regimen | Drug and dosing | Duration |
|---|---|---|
| Empiric therapy | ||
| Bismuth quadruple therapy | Bismuth subsalicylate 300 mg 4 times daily, 30 minutes before meals Tetracycline 500 mg 4 times daily, 30 minutes after meals Metronidazole 500 mg 4 times daily, 30 minutes after meals Proton pump inhibitor (standard dose) twice daily, 30 minutes before meals and at bedtime, or before morning and evening meals | 14 days |
| Bismuth quadruple therapy (Pylera) | Combination pill containing bismuth, tetracycline, and metronidazole 4 times daily with meals and at bedtime Proton pump inhibitor (standard dose) twice daily, 30 minutes before meals and at bedtime | 14 days |
| Susceptibility-based therapy | ||
| Clarithromycin triple therapy | Clarithromycin 500 mg twice daily, 30 minutes after meals Amoxicillin 1 g twice daily, 30 minutes after meals Proton pump inhibitor (standard dose) twice daily, 30 minutes before meals | 14 days |
| Metronidazole triple therapy | Metronidazole 500 mg twice daily, 30 minutes after meals Amoxicillin 1 g twice daily, 30 minutes after meals Proton pump inhibitor (standard dose) 3 times daily, 30 minutes before meals | 14 days |
| Levofloxacin triple therapy | Levofloxacin 500 mg daily, 30 minutes after meal Amoxicillin 1 g twice daily, 30 minutes after meals Proton pump inhibitor (standard dose) twice daily, 30 minutes before meals | 14 days |
Based on information from reference 15.