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. Author manuscript; available in PMC: 2011 Mar 1.
Published in final edited form as: J Clin Gastroenterol. 2010 Mar;44(3):167–172. doi: 10.1097/MCG.0b013e3181c64c69

Table 2.

Four-drug therapies for H. pylori in the era of prevalent clarithromycin resistance

  1. Sequential regimen: PPI + 1 gm amoxicillin b.i.d. for 5 days, followed by PPI + 500 mg clarithromycin + 500 mg metronidazole/tinidazole b.i.d. for 5 days)

  2. Concomitant regimen: PPI + 1 gm amoxicillin + 500 mg clarithromycin + 500 mg metronidazole/tinidazole all b.i.d. for 10 to 14 days

  3. Bismuth quadruple therapy: PPI of choice b.i.d., bismuth tablets 2 q.i.d. (420 mg bismuth subcitrate or 524 mg bismuth subsalicylate), tetracycline HCl 500 mg q.i.d., metronidazole/tinidazole 500 gm t.i.d. (drugs often given with meals and when q.i.d. also at bedtime)