Table 1: Recommended regimens for Helicobacter pylori therapy.

TreatmentRegimen

First-line treatments
 Sequential therapyA 5 d dual therapy with a PPI (standard dose, b.i.d.) and amoxicillin (1 g, b.i.d.) followed by a 5 d triple therapy with a PPI (standard dose, b.i.d.), clarithromycin (500 mg, b.i.d.), and metronidazole (500 mg, b.i.d.)
 Concomitant therapyA PPI (standard dose, b.i.d.), clarithromycin (500 mg, b.i.d.), amoxicillin (1 g, b.i.d.), and metronidazole (500 mg, b.i.d.) for 7–10 d
 Hybrid therapyA 7 d dual therapy with a PPI (standard dose, b.i.d.) and amoxicillin (1 g, b.i.d.) followed by a 7 d quadruple therapy with a PPI (standard dose, b.i.d.), amoxicillin (1 g, b.i.d.), clarithromycin (500 mg, b.i.d.), and metronidazole (500 mg, b.i.d.)
 Bismuth-containing quadruple therapyA PPI (standard dose, b.i.d.), bismuth (standard dose, q.i.d.), tetracycline (500 mg, q.i.d.), and metronidazole (500 mg, t.i.d.) for 10–14 d

Second-line/Salvage treatments
 Levofloxacin-based triple therapyA PPI (standard dose, b.i.d.), levofloxacin (500 mg, b.i.d.), and amoxicillin (1 g, b.i.d.) for 10 d
 Bismuth-containing quadruple therapyA PPI (standard dose, b.i.d.), bismuth (standard dose, q.i.d.), tetracycline (500 mg, q.i.d.), and metronidazole (500 mg, t.i.d.) for 14 d
 Standard triple therapy*A PPI (standard dose, b.i.d.), amoxicillin (1 g, b.i.d.), and clarithromycin (500 mg, b.i.d.) for 14 days
 Levofloxacin-based sequential therapy**A 5 d dual therapy with a PPI (standard dose, b.i.d.) and amoxicillin (1 g, b.i.d.) followed by a 5 d triple therapy with a PPI (standard dose, b.i.d.), levofloxacin (250 mg, b.i.d.), and amoxicillin (1 g, b.i.d.)
 Amoxicillin-based dual therapy (high dose) A PPI (high dose, t.i.d) and Amoxicillin (1 g, t.i.d.) for 14 days
 Rifabutin-based triple therapy A PPI (standard dose, b.i.d.), rifabutin (150 mg b.i.d.), and amoxicillin (1 g b.i.d.) for 14 d
 Furazolidone-based quadruple therapy A PPI (standard dose, b.i.d.), tripotassium dicitratobismuthate (240 mg, b.i.d.), furazolidone (200 mg, b.i.d.), and tetracycline (1 g, b.i.d.)

*Employed after antibiotic susceptibility testing; **regimen under evaluation; regimen usually employed as third-line therapy; PPI: proton pump inhibitor.