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The Helicobacter pylori (H. pylori) eradication table offers a succinct yet quick guide for primary care clinicians on how to approach treatment as recommended by BNF. It provides a series of stepped regimens tailored to specific patient needs, including those with penicillin allergies or previous treatment histories that might contribute to antibiotic resistance. The table also emphasizes the importance of considering specialist referrals for persistent infections and offers Public Health England (PHE) guidelines for specific clinical scenarios, such as the onset of diarrhoea. This resource aims to serve as a quick reference to optimize antibiotic selection, reduce the emergence of resistant strains, and guide clinicians in providing the most effective treatment options.
| Aspect | Recommendations |
|---|---|
| Standard Treatment | Triple therapy: Proton Pump Inhibitor + two antibacterials |
| First-Line Choices | Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole Sodium |
| Antibacterial Choices | Amoxicillin, Clarithromycin, Metronidazole, Tetracycline, Levofloxacin |
| Considerations | Past antibacterial use to avoid resistance |
| Post Second-Line | Refer to a specialist if H. pylori remains |
| Diagnostic Measures | Endoscopy, culture, and susceptibility tests advised for complicated cases |
| Side Effects | Consider C. difficile if diarrhoea occurs; review treatment |
Choice of agents
| Aspect | No Penicillin Allergy | Penicillin Allergy |
|---|---|---|
| First-Line Therapy (7 days) | Proton Pump Inhibitor + Amoxicillin + (Clarithromycin or Metronidazole) | Proton... |
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