Sandbox MKK

The ACG’s 2007 treatment guideline on the management of H. pylori infection (26) listed the following as established indications for diagnosis and treatment:

Active PUD (gastric or duodenal).

Confirmed history of PUD (not previously treated for H. pylori)

Gastric MALT lymphoma (low grade).

After endoscopic resection of EGC.

Recommenend first line treatment for Helicobacter pylori

Regimen	Drug dose	Dosing frequency	Duration(days)
Clarithromycin triple	PPI(standard or double dose Clarithromycin(500mg) Amoxicillin(1gm)or Metronidazole(500mg TID)	BID	14 days
Bismuth Quadruple	PPI(standard dose) Bismuth subcitrate (120-300mg)or Subsalicylate (300mg) Tetracyclin(500mg) Metronidazole(250-500mg)	BID QID QID TID to QID (500mg)	10-14 days
Concomitant	PPI (standard dose) Clarithromycin (500mg) Amoxicillin(1gm) Nitroimidazole(500mg)	BID	10 -14 days
Sequential	PPI(standard dose)+Amoxicillin(1gm) PPI,Clarithromycin(500mg)+Nitroimidazole(500mg)	BID BID	5-7 days 5-7 days
Hybrid	PPI(standard)+Amoxicillin(1gm) PPI,Amoxicillin,Clarithromycin(500mg),Nitroimidazole(500mg)	BID BID	7 days 7 days
Levofloxacin triple	PPI(standard dose) Levofloxacin(500mg) Amoxicillin(1gm)	BID QID BID	10-14 days
Levofloxacin sequential	PPI(standard or double dose)+Amoxicillin(1 gm) PPI,Amoxicillin,Levofloxacin(500mg QD),Nitroimidazole(500mg)	BID BID	5-7 days
LOAD	Levofloxacin(250mg) PPI(double dose) Nitazoxanide(500mg) Doxycycline(100mg)	QD QD BID QD	7-10 days

Adjuvant therapy in the treatment of H. pylori infection. Emerging evidence suggests an inhibitory effect of Lactobacillus and Bifidobacterium species on H. pylori. Furthermore, these probiotic strains may also help to reduce the side effects of eradication therapies and improve compliance with therapy.

Selection of a first-line H. pylori treatment regimen:

             |,|-|-|+|-|-|^|-|-|.|   
             B01    B02   B03   B04

A01