Gastric mucosa-associated lymphoid tissue lymphoma and Helicobacter pylori infection: a review of current diagnosis and management

Table 3 First-Line Regimens for Helicobacter pylori Eradication (ACG Guideline 2007) [7]

Regimen	Duration (days)	Eradication Rates	Comments
Triple therapy: ^∗Standard dose PPI b.i.d. (esomeprazole is q.d.), clarithromycin 500 mg b.i.d., amoxicillin 1,000 mg b.i.d.	10–14	70–85 %	Consider in non-penicillin-allergic patients who have not previously received a macrolide
Triple therapy (penicillin allergic): Standard dose PPI b.i.d., clarithromycin 500 mg b.i.d., metronidazole 500 mg b.i.d.	10–14	70–85 %	Consider in penicillin-allergic patients who have not previously received a macrolide or are unable to tolerate bismuth quadruple therapy
Bismuth therapy: Bismuth subsalicylate 525 mg p.o. q.i.d. metronidazole 250 mg p.o. q.i.d., tetracycline 500 mg p.o. q.i.d., ranitidine 150 mg p.o. b.i.d. or standard dose PPI q.d. to b.i.d.	10–14	75–90 %	Consider in penicillin-allergic patients
Sequential therapy: PPI + amoxicillin 1 g b.i.d. ×5 followed by: PPI, clarithromycin 500 mg, tinidazole 500 mg b.i.d. ×5	10	>90 %	Requires validation in North America

Note: The above recommended treatments are not all FDA approved. The FDA-approved regimens are as follows:
Bismuth 525 mg q.i.d. + metronidazole 250 mg q.i.d. + tetracycline 500 mg q.i.d. × 2 weeks + H₂RA as directed × 4 weeks
Lansoprazole 30 mg b.i.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 10 days
Omeprazole 20 mg b.i.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 10 days
Esomeprazole 40 mg q.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 10 days
Rabeprazole 20 mg b.i.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 7 days
ACG American College of Gastroenterology, PPI proton pump inhibitor, p.o. orally, q.d. daily, b.i.d. twice daily, t.i.d. three times daily, q.i.d. four times daily
^∗ Standard dosages for PPIs are as follows: lansoprazole 30 mg p.o., omeprazole 20 mg p.o., pantoprazole 40 mg p.o., rabeprazole 20 mg p.o., esomeprazole 40 mg p.o

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