Helicobacter pylori eradication in West Asia: A review

Table 5 Recommended treatment regimens for Helicobacter pylori eradication in West Asia

First-line therapeutic options:

10-d Bismuth-Furazolidone Quadruple therapy:

Pantoprazole 40 mg BD + Amoxicillin 1 g BD + Bismuth 240 mg BD for 10 d; Metronidazole 500 mg BD just over the first 5 d and Furazolidone 200 mg BD over the second 5 d

14-d Clarithromycin-containing Hybrid therapy:

Pantoprazole 40 mg BD + Amoxicillin 1 g BD for 14 d and Clarithromycin 500 mg BD + Tinidazole 500 mg BD just over the last 7 d

14-d Omeprazole-Bismuth-Tetracycline-Metronidazole, if:

Omeprazole 20 mg BD + Bismuth 240 mg BD + Tetracycline 500 mg QID + Metronidazole 500 mg TDS for 14 d

Second-line therapeutic options:

14-d Omeprazole-Bismuth-Tetracycline-Furazolidone:

Omeprazole 20 mg BD + Bismuth 240 mg BD + Tetracycline 500 mg BD + Furazolidone 200 mg BD (if Furazolidone is not used as first-line)

14-d Ranitidine-Bismuth-Tetracycline-Metronidazole:

Ranitidine-Bismuth 400 mg BD + Tetracycline 500 mg BD + Metroidazole 500 mg BD

7-d Rabeprazole-Amoxicillin-Gatifloxacin:

Rabeprazole 20 mg BD + Amoxicillin 1 g BD + Gatifloxacin 400 mg Daily

14-d Omeprazole-Bismuth-Azithromycin-Ofloxacin:

Omeprazole 20 mg BD + Bismuth 240 mg BD + Azithromycin 250 mg BD + Ofloxacin 200 mg BD

Third-line therapeutic options:

The optimal regimen must be chosen according to the pattern of antibiotic susceptibility of H. pylori1

¹Rifabutin-containg triple therapy may also be a suitable option[100,101]. BD: Twice a day; TDS: Three times a day; QID: Four times a day; H. pylori: Helicobacter pylori.