|
| First-line treatment regimens |
|
| Triple standard therapy | PPI + CAM + AMPC
and/or MNZ | Eradication of HP infection from 90% to 70–80% Steadily decline in treatment efficacy in USA [7]
|
| Sequential therapy | PPI + AMPC for 5 days, then PPI + CAM + MNZ for other 5 days | Eradication rates of 90%–94% [8, 9] |
| Concomitant therapy | PPI + CAM + AMPC + MNZ for 7–10 days | Eradication rate of 90%. More simple regimen, good alternative to standard triple therapy [10] |
| Bismuth-based quadruple therapy | PPI + Bismuth + Tetracycline + MNZ for 10–14 days | Important role in countries with high CAM resistance rate; in a recent study patients took PPI and a three-in-one capsule containing bismuth subcitrate potassium, MNZ and Tetracycline with eradication rates of 80% versus 55% in the standard therapy group [11] |
|
| Second-line treatment regimens |
|
| Levofloxacin-based triple therapy | PPI, levofloxacin, and AMPC | Good alternative for patients who failed with standard treatment. A recent meta-analysis highlighted that levofloxacin-based triple therapy has lower incidence in side effects than the bismuth-based quadruple therapy, as well as a better eradication rate (87% versus 68%) [12]
|
| Rifabutin-containing rescue therapy | | Well tolerated, good alternative for patients who failed with a first-line therapy [13] |
|
