Attempts to enhance the eradication rate of Helicobacter pylori infection

Table 1 Treatment regimens for Helicobacter pylori eradication

Treatment	Regimens	Duration
Standard triple therapy	PPI (standard dose), amoxicillin (1 g), and clarithromycin (500 mg) twice daily	7-14 d
	PPI (standard dose), metronidazole (500 mg), and clarithromycin (500 mg) twice daily
Bismuth containing quadruple therapy	PPI (standard dose) twice daily, bismuth (standard dose), metronidazole (500 mg), and tetracycline (500 mg) four times daily	10-14 d
Sequential therapy	PPI (standard dose) and amoxicillin (1 g) twice daily for 5 d, followed by PPI (standard dose), metronidazole (500 mg), and clarithromycin (500 mg) twice daily for 5 d	10 d
Concomitant therapy (Non-bismuth quadruple therapy)	PPI (standard dose), amoxicillin (1 g), metronidazole (500 mg), and clarithromycin (500 mg) twice daily	10 d
Hybrid therapy	PPI (standard dose), amoxicillin (1 g) twice daily for 7 d, followed by PPI (standard dose), amoxicillin (1 g), metronidazole (500 mg), and clarithromycin (500 mg) twice daily for 7 d	14 d
Levofloxacin-based triple therapy	PPI (standard dose), amoxicillin (1 g), and levofloxacin (500 mg) twice daily	10 d
LOAD regimen	Levofloxacin (250 mg) with breakfast, omeprazole (40 mg) before breakfast, nitazoxanide (500 mg) twice daily with meals, and doxycycline (100 mg) at dinner	7 d or 10 d
Rifabutin-based triple therapy	PPI (standard dose), amoxicillin (1 g), and rifabutin (150 mg) twice daily	7-14 d
Furazolidone-based quadruple therapy	Lansoprazole (30 mg), tripotassiumdicitratobismuthate (240 mg), tetracycline (1 g), and furazolidone (200 mg) twice daily	7 d
Novel quadruple therapy	PARC; rabeprazole (20 mg, thrice daily for 10 d), amoxicillin (1000 mg, thrice daily for 10 d), rifabutin (150 mg, starting from day 6, twice daily for 5 d), and ciprofloxacin (500 mg, starting from day 6, twice daily for 5 d)	10 d
	PBRC (allergic to amoxicillin); rabeprazole (20 mg, thrice daily for 10 d), bismuth subcitrate (240 mg, 4 times daily for 10 d), rifabutin (150 mg, twice daily for 10 d), and ciprofloxacin (500 mg, twice daily for 10 d)
High dose dual therapy	Lansoprazole (30 mg) and amoxicillin (750 mg) thrice daily	14 d

PPI: Proton pump inhibitor.

Table 2 Current recommended first line regimens of Helicobacter pylori eradication

Guidelines	Regimens	Duration
Maastricht IV/Florence (2012)[6]	Clarithromycin containing treatments in areas of low clarithromycin resistance (Bismuth-containing quadruple treatment is an alternative)	7-14 d
	Bismuth-containing quadruple treatment in areas of high clarithromycin resistance (if not available, sequential treatment or non-bismuth quadruple treatment is recommended)	-
		-
Asian Pacific (2009)[15]	Standard PPI-based triple therapy	7 d
	(Bismuth-containing quadruple treatment is an alternative)	-
American College (2007)[14]	Standard PPI-based triple therapy OR	14 d
	Bismuth-containing quadruple treatment	10-14 d
	(Sequential therapy may be an alternative)	-
South Korea (2013)[82]	Standard PPI-based triple therapy	7-14 d
	(Bismuth-containing quadruple treatment is an alternative)	7-14 d
Japan (2009)[16]	Standard PPI-based triple therapy	7 d
Canada (2005)[112]	Standard PPI-based triple therapy	14 d
ESPGHAN and NASPGHAN for children (2011)[113]	Standard PPI-based triple therapy	-
	Bismuth-containing quadruple treatment	10-14 d
	Sequential therapy	10 d

PPI: Proton pump inhibitor; ESPGHAN and NASPGHAN: European and North American Societies of Pediatric Gastroenterology Hepatology and Nutrition.