Helicobacter pylori Therapies and Treatments
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Helicobacter Pylori Therapies and Treatments

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Helicobacter pylori Therapies and Treatments


Conventional First-Line Triple Therapies (Twice-Daily PPI-Based Triple Therapies)

Cure rate 90%:with 2 weeks treatment  in the U.S.; 1 week Treatment outside U.S.

  • Omeprazole 20 mg bid or Lansoprazole 30 mg bid
  • Clarithromycin 500 mg bid
  • Amoxicillin 1 g bid
  • or Metronidazole 500 mg bid if Amoxicillin intolerant

Traditional Bismuth-Based Triple Therapy (also for Penicillin Allergic Patients)

Cure rate 80% with 2 weeks Treatment (USA) ;Cure rate outside U.S.A.: 90% with 1-2 weeks Treatment

  • De-Nol [Colloidal bismuth subcitrate ]* 120mg qid outside U.S.)
    • Tetracycline 500 mg qid
    • Metronidazole 400 mg qid
    • Proton  Pump Inhibitor (20mg Omeprazole bid or 30 mg lansoprazole. bid

*De-Nol (Colloidal Bismuth Subcitrate) is Available in Australia Under the TGA’s Special Access Scheme (SAS) Contact Tri-Med Distributors P/L; Email sales@trimed.com.au


Furazolidone & Bismuth Based (Second Line) Quadruple Therapies

Cure Rate >92% Duration of Treatment 14 days

  • Furazolidone 200mg bid
  • Colloidal Bismuth Subcitrate (De-Nol) 120mg qid
  • Amoxicillin 1000mg bid
  • 20mg Omeprazole bid OR 30 mg lansoprazole. bid

Third-Line Quadruple “Salvage Therapy” (Marshall Therapy)

  • Ciprofloxacin 500mg bid
  • Rifabutin* 150mg bid
  • Omeprazole 40mg tds (six times the normal dose)
  • Amoxycillin 1000mg tds

* Rifabutin is only available through a Hospital Pharmacy


Other Triple Therapies – Twice-Daily RBC-Based Triple Therapy

Cure rate 90% with  2 weeks treatment

  • Ranitidine bismuth citrate (RBC)* 400 mg bid
  • Clarithromycin 500 mg bid
  • Amoxicillin 1 g bid (or metronidazole 500 mg bid if Amoxicillin intolerant)

*RBC has been de-listed in Australlia; However, De-Nol can be substituted for RBC.  De-Nol is Available in Australia Under the TGA’s Special Access Scheme (SAS)  Contact Tri-Med Distributors P/L; Email sales@trimed.com.au


Other US-FDA-Approved  Dual Therapies 

Cure rate 70% at 2 weeks

  • Omeprazole 40 mg qid
  • Clarithromycin 500 mg tid

Cure rate 80% at 2 weeks

  • Ranitidine bismuth citrate 400 mg bid
  • Clarithromycin 500 mg tid

 

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