Dysbiosis: Helicobacter pylori - the drug regimes to treat

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If an infection with Helicobacter pylori is confirmed by a test (the best way to detect present infection is by doing a Helicobacter Pylori breath test), then a course of eradication therapy is required to clear the infection. Eradication therapy has to be prescribed by a doctor/physician. The majority of patients need to have a one week course of treatment, but some may require a two week course. Antacid blockers (such as omeprazole, lansoprazole, pantoprazole) may need to be continued for 4-8 weeks to promote ulcer healing (particularly after ulcer haemorrhage or perforation).

Some physicians find that eradication therapy in patients with reflux oesophagitis doesn't improve them in the long term and are not indicated. I believe this is because they do not address the underlying causes which will be similar to those causing ulcer disease. See Acidity and ulcer disease. H. pylori is a risk factor for arterial disease so it is best to get rid of it.

Regimes recommended by the British National Formulary

REGIMES CONTAINING CLARITHROMYCIN

  • Omeprazole 20mg twice daily
    Clarithromycin 500 mg twice daily
    Amoxicillin 1g twice daily
  • Lansoprazole 30 mg twice daily
    Clarithromycin 500 mg twice daily
    Amoxicillin 1g twice daily
  • Pantoprazole 40 mg twice daily
    Clarithromycin 500 mg twice daily
    Amoxicillin 1g twice daily
  • Omeprazole 20mg twice daily
    Clarithromycin 500 mg twice daily
    Metronidazole 400 mg twice daily
  • Lansoprazole 30 mg twice daily
    Clarithromycin 500 mg twice daily
    Metronidazole 400 mg twice daily
  • Pantoprazole 40 mg twice daily
    Clarithromycin 500 mg twice daily
    Metronidazole 400 mg twice daily
  • Ranitidine bismuth citrate 400 mg twice daily
    Clarithromycin 500 mg twice daily
    Metronidazole 400 mg twice daily

REGIMES WHICH DO NOT CONTAIN CLARITHROMYCIN

  • Omeprazole 20mg twice daily
    Amoxicillin 500 mg three times daily
    Metronidazole 400 mg three times daily
  • Lansoprazole 30 mg twice daily
    Amoxicillin 1g twice daily
    Metronidazole 400 mg twice daily
  • Ranitidine bismuth citrate 400 mg twice daily
    Amoxicillin 1g twice daily
    Metronidazole 400 mg twice daily

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