Evidence-Based Treatment Protocols
- H.pylori eradication requires careful selection of antibiotic combinations based on local resistance patterns, patient factors, and treatment history. Our protocols emphasise high eradication rates while minimising side effects.
Triple Therapy Regimens
Standard triple therapy combines a proton pump inhibitor with two antibiotics, typically clarithromycin and amoxicillin (or metronidazole in penicillin-allergic patients). Treatment duration and specific agents are selected based on resistance data and patient factors.
Quadruple Therapy Options
Bismuth-based quadruple therapy provides excellent eradication rates, particularly in areas with high clarithromycin resistance. This regimen combines bismuth subsalicylate, metronidazole, tetracycline, and a proton pump inhibitor.
Sequential and Concomitant Therapies
Alternative regimens offer improved eradication rates in challenging cases, with careful attention to patient compliance and side effect management.
Treatment Monitoring
Post-treatment testing confirms eradication using appropriate methods (urea breath test or stool antigen) performed at least four weeks after treatment completion and after stopping acid suppression.
Resistance Considerations
Knowledge of local resistance patterns guides initial therapy selection. Treatment failure requires investigation of resistance patterns and selection of alternative regimens with different antibiotic combinations.
