Helicobacter pylori: Difference between revisions
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Helicobacter pylori
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+ | == Background == |
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+ | == Management == |
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+ | * Duration: 14 days |
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+ | * First-line: |
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+ | ** PBMT (PPI, bismuth, [[metronidazole]], [[tetracycline]]) |
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+ | ** PAMC (PPI, [[amoxicillin]], [[metronidazole]], [[clarithromycin]]) |
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+ | ** PAC (PPI, [[amoxicillin]], [[clarithromycin]]), PMC (PPI, [[metronidazole]], [[clarithromycin]]), or PAM (PPI, [[amoxicillin]], [[metronidazole]]) only in areas with clarithromycin resistance <15% or with proven high local eradication rates >85% |
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+ | * Prior treatment failure: |
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+ | ** PBMT (PPI, bismuth, [[metronidazole]], [[tetracycline]]) |
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+ | ** PAL (PPI, [[amoxicillin]], [[levofloxacin]]) |
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+ | ** PAR (PPI, [[amoxicillin]], [[rifabutin]]) as last-line |
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+ | * Doses: |
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+ | ** PBMT |
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+ | *** Bismuth subsalicylate 262 mg 2 tablets PO qid |
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+ | *** [[Metronidazole]] 500 MG PO tid or qid |
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+ | *** PPI: esomeprazole 20 mg, lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg, or rabeprazole 20 mg |
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+ | **** Some areas use double dosing |
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+ | *** Tetracycline 500 mg PO qid |
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+ | ** Others |
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+ | *** Amoxicillin 1000 mg PO bid |
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+ | *** Clarithromycin 500 mg PO bid |
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+ | *** Levofloxacin 500 mg PO daily |
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+ | *** Metronidazole 500 mg PO bid |
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+ | *** Rifabutin 150 mg PO bid |
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+ | *** PPI as above |
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{{DISPLAYTITLE:''Helicobacter pylori''}} |
{{DISPLAYTITLE:''Helicobacter pylori''}} |
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[[Category:Gram-negative bacilli]] |
[[Category:Gram-negative bacilli]] |
Revision as of 21:37, 7 March 2021
Background
- Slow-growing Gram-negative microaerophilic bacillus with a curve, gull-wing, or spiral appearance
- Oxidase-positive and urease-positive
- Major cause of peptic ulcer disease and gastric cancer
Management
- Duration: 14 days
- First-line:
- PBMT (PPI, bismuth, metronidazole, tetracycline)
- PAMC (PPI, amoxicillin, metronidazole, clarithromycin)
- PAC (PPI, amoxicillin, clarithromycin), PMC (PPI, metronidazole, clarithromycin), or PAM (PPI, amoxicillin, metronidazole) only in areas with clarithromycin resistance <15% or with proven high local eradication rates >85%
- Prior treatment failure:
- PBMT (PPI, bismuth, metronidazole, tetracycline)
- PAL (PPI, amoxicillin, levofloxacin)
- PAR (PPI, amoxicillin, rifabutin) as last-line
- Doses:
- PBMT
- Bismuth subsalicylate 262 mg 2 tablets PO qid
- Metronidazole 500 MG PO tid or qid
- PPI: esomeprazole 20 mg, lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg, or rabeprazole 20 mg
- Some areas use double dosing
- Tetracycline 500 mg PO qid
- Others
- Amoxicillin 1000 mg PO bid
- Clarithromycin 500 mg PO bid
- Levofloxacin 500 mg PO daily
- Metronidazole 500 mg PO bid
- Rifabutin 150 mg PO bid
- PPI as above
- PBMT