Gastroenterology

Let’s talk H. Pylori Treatment! 💊

⭐️ H. pylori is a type of bacteria that infects your stomach and causes damage to the tissue leading to peptic ulcers, inflammation, and gastritis.

⭐️ Treatment includes:

1️⃣ Medications that decrease stomach acid to help decrease damage to tissues (ex: PPI or H2-antagonist)

2️⃣ Medications such as bismuth subsalicylate (AKA Pepto-Bismol) that coats the stomach protecting it from stomach acid (also has anti-inflammatory properties and antimicrobial activity against H. Pylori)

3️⃣ At least 2 antibiotics in the regimen to prevent the bacteria from developing resistance to the antibiotics (ex: amoxicillin, tetracycline, metronidazole, or clarithromycin)

⭐️ Initial therapy for H. Pylori includes:

👉 Bismuth quadruple therapy and concomitant (non-bismuth quadruple therapy), both administered for 10-14 days, are recommended FRIST-LINE treatments.

👉 In penicillin-allergic patients, bismuth quadruple therapy is the preferred initial treatment. Consider referral for allergy testing in patients who fail initial therapy, since many patients who report penicillin allergy are not truly allergic.

👉 Alternative initial therapies include sequential, hybrid, levofloxacin-tripe, levofloxacin sequential, and LOAD therapies.