Development of Helicobacter pylori treatment: How do we manage antimicrobial resistance?

Table 1 Treatment regimens for first-line Helicobacter pylori therapies and its successful eradication rates

Regimens	PPI	Antibiotics	Treatment duration	Eradication rates
Bismuth quadruple therapy	Esomeprazole 20-40 mg bid; Omeprazole 20-40 mg bid	TC 125 mg qid; MNZ 125 mg qid	10 d	90%[35]
Concomitant quadruple therapy	Esomeprazole 20-40 mg bid; Lansoprazole 30 mg bid; Omeprazole 20-40 mg bid; Pantoprazole 40 mg bid; Rabeprazole 10-20 mg bid	AMPC 750 mg-1 g bid; CAM 200-500 mg bid; MNZ or TNZ 250-500 mg bid	5-14 d	83%[36]
Standard triple therapy	Esomeprazole 40 mg bid; Lansoprazole 30 mg bid; Pantoprazole 40 mg bid; Rabeprazole 10-20 mg bid	AMPC 500 mg-1 g bid; CAM 200-500 mg bid	7 d[37]; 14 d[38]	73%[37]; 81%[38]
High dose dual therapy	Esomeprazole 20 mg qid; Omeprazole 40 mg qid; Rabeprazole 10-20 mg qid	AMPC 750 mg qid	14 d	86%[39]
Vonoprazan based triple therapy	vonoprazan 20 mg bid	AMPC 750 mg bid; CAM 200-400 mg bid	7 d	88%[37]
Vonoprazan based dual therapy	vonoprazan 20 mg bid	AMPC 500 mg tid	7 d	94%[32]

PPI: Proton pump inhibitor; TC: Tetracycline; MNZ: Metronidazole; AMPC: Amoxicillin; CAM: Clarithromycin; TNZ: Tinidazole.