Treatment for Helicobacter pylori
The table below was developed by Barry J. Marshall M.D., and Dr. Loren Laine M.D. The table is published at Physicians On-Line , a dial-up service provided free to physicians in the United States. The data was presented at the American Gastrointestinal Association conference held in San-Diego California in May 1995. Data was still valid as of September 1995
*** please pay attention to footnotes marked with asterisks "*"
Bismuth/Tetra/Metro "Triple Therapy" (with acid reduction)
cure rate 95% in 7-14 days
- famotidine 40 mg daily (or equivalent full dose H2 blocker) or omeprazole 20 mg daily
tetracycline 500 mg q.i.d.
metronidazole 250 mg 4 times daily
De-Nol 1 tab q.i.d. or bismuth subsalicylate 2 tabs q.i.d.
omeprazole, amoxicillin, metronidazole
cure rate 90% in 7 days
- omeprazole 20 mg b.i.d.
amoxicillin 500 mg q.i.d.
metronidazole 250 mg q.i.d.
omeprazole, clarithromycin-metronidazole
cure rate 90-95% in 7 days*
- omeprazole 20 mg b.i.d. (or 40 mg q.am.)
clarithromycin 500 mg b.i.d.
metronidazole 500 mg b.i.d.
* I understand that clarithromycin is approved in Australia but is not NHS listed and so will cost about $100 (it's probably worth it!). You may have to order it in to your pharmacy.
omeprazole, amoxicillin, clarithromycin
90-95% cure in 14 days**
- omeprazole 20 mg b.i.d.
amoxicillin 500 mg q.i.d.
clarithromycin 500 mg b.i.d.
** This "heavy duty" therapy should be used in patients who have previously failed one of the other three. After two failed therapies, culture and antibiotic sensitivity testing might also be required.
- Loren Laine MD
University of Southern California
2025 Zonal Ave
Los Angeles, CA, USA 90033.
Barry J Marshall F.R.A.C.P., M.D.,
Clinical Associate Professor of Medicine,
University of Virginia Health Sciences Center
Click here Dr. Marshall's best Mailing Address
