Table 1.
Current recommendations for Helicobacter pylori eradication
| Treatment | Region with low clarithromycin prevalence | Region with high clarithromycin prevalence |
| First line | PPI - clarithromycin - amoxicillin/metronidazole or bismuth quadruple | Bismuth quadruple1. If not available: non-bismuth quadruple (either sequential or concomitant) |
| Second line | Bismuth quadruple1 or PPI - levofloxacin/amoxicillin | PPI - levofloxacin/amoxicillin |
| Third line | Based on susceptibility testing only. Besides clarithromycin and levofloxacin, rifabutin is another candidate that may be used | |
1
PPI + tetracyclines + bismuth + metronidazole. PPI: Proton pump inhibitors.