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

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

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
  1. Note: The above recommended treatments are not all FDA approved. The FDA-approved regimens are as follows:
  2. 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
  3. Lansoprazole 30 mg b.i.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 10 days
  4. Omeprazole 20 mg b.i.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 10 days
  5. Esomeprazole 40 mg q.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 10 days
  6. Rabeprazole 20 mg b.i.d. + clarithromycin 500 mg b.i.d. + amoxicillin 1 g b.i.d. × 7 days
  7. 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
  8. 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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