Helicobacter Pylori - Treatments

Not ready to share? Read other Patient Comments

What was the treatment for your Helicobacter Pylori?

Share your story with others:

MedicineNet appreciates your comment. Your comment may be displayed on the site and will always be published anonymously.Patient Comments FAQs

Enter your Comment

Tell us a bit about your background to make your comments more useful to other MedicineNet users. (Optional)

Screen Name: *

Gender of Patient: Male Female

Age Range of Patient:

I am a: Patient Caregiver

* Screen Name will appear next to the published comment. Please do not include your full name or email address.

By submitting your comment, and other materials (collectively referred to as a "Submission") to MedicineNet, you grant MedicineNet permission to use, copy, transmit, publish, display, edit and modify your Submission in connection with its Web site. MedicineNet will not pay you for your Submission. You represent that you have all rights necessary for MedicineNet to use your Submission as set forth above.

Please keep these guidelines in mind when writing your comment:

  • Please make sure you address the question asked.
  • Due to the overwhelming number of comments received, not all comments will be published.
  • When selecting comments to publish, our staff will choose those that are educational and complement the topic. Please try to stay on topic.
  • Your comment may be edited. We would typically edit comments to make them clearer and more readable. We will remove personal information such as last names, email and web addresses, and other potentially harmful information.
  • We will not notify you if your comment has been published. We suggest that you check back on the topic article regularly.
  • We do not provide medical or healthcare advice, treatment, or diagnosis.

Thank you for participating!

I have read and agree to abide by the MedicineNet Terms and Conditions and the MedicineNet Privacy Policy (required).

To prevent our systems from spam, please complete the following prior to submitting your comment.

Please select the white square:

What is the treatment for H. pylori?

H. pylori is difficult to eradicate from the stomach because it is capable of developing resistance to commonly used antibiotics. Therefore, two or more antibiotics usually are given together with a PPI and/or bismuth containing compounds to eradicate the bacterium. (Bismuth and PPIs have anti-H. pylori effects.) Examples of combinations of medications that are effective are:

  • a PPI, amoxicillin (Amoxil) and clarithromycin (Biaxin)
  • a PPI, metronidazole (Flagyl), tetracycline and bismuth subsalicylate (Pepto-Bismol, Bismuth)

These combinations of medications can be expected to cure 70% to 90% of infections. However, studies have shown that resistance of H. pylori (failure of antibiotics to eradicate the bacterium) to clarithromycin is common among patients who have prior exposure to clarithromycin or other chemically similar macrolide antibiotics (such as erythromycin). Similarly, H. pylori resistance to metronidazole is common among patients who have had prior exposure to metronidazole. In these patients, doctors have to find other combinations of antibiotics to treat the H. pylori. Antibiotic resistance is another reason why antibiotics should be used carefully and judiciously for the right reasons, and indiscriminate use of antibiotics for improper reasons should be discouraged. First-line regimens for Helicobacter pylori eradication are taken from the guidelines developed by the American College of Gastroenterology as follows:

  1. Standard dose of a *PPI (proton pump inhibitor) *b.i.d. (esomeprazole is *q.d.), clarithromycin 500 mg b.i.d., amoxicillin 1,000 mg b.i.d. for 10-14 days
  2. Standard dose PPI b.i.d., clarithromycin 500 mg b.i.d. metronidazole 500 mg b.i.d. for 10-14 days
  3. Bismuth subsalicylate 525 mg p.o. q.i.d. metronidazole 250 mg * p.o. *q.i.d., tetracycline 500 mg p.o. q.i.d., ranitidine 150 mg p.o. b.i.d. or standard dose PPI q.d. to b.i.d. for 10-14 days
  4. PPI + amoxicillin 1 g b.i.d., for 5 days, followed by PPI, clarithromycin 500 mg, tinidazole 500 mg b.i.d. for 5 days (used mainly in other countries)

*PPI = proton pump inhibitor; pcn = penicillin; p.o. = orally; q.d. = daily; b.i.d. = twice daily; t.i.d. = three times daily; q.i.d. = four times daily.

A recent investigation reported that triple therapy of either levofloxacin (Levaquin) or rifabutin in combination with amoxicillin and esomeprazole yielded cure rates of 90% and 88.6%. The treatments lasted 10 to 12 days respectively (10 days of levofloxacin 20=50 mg b.i.d. or rifabutin 150 mg q.d. for 12 days. Amoxicillin was 1 gm esomeprazole was 40 mg, both b.i.d.).

Some doctors may want to confirm eradication of H. pylori after treatment with a urea breath test or a stool antigen test, particularly if there have been serious complications of the infection such as perforation or bleeding in the stomach or duodenum. Endoscopic biopsies to determine eradication of the bacterium are not necessary, and blood tests are not good for determining eradication since it takes many months or years for the antibodies to H. pylori to decrease. The best tests for determining eradication are the breath and stool tests discussed previously. Patients who fail to eradicate H. pylori with treatment are retreated, often with a different combination of medications.

Return to Helicobacter Pylori
(H. pylori)

See what others are saying

Comment from: Natural health, 45-54 Female (Patient) Published: March 18

I have Helicobacter pylori. I was very sick off and on for years. Because I am very healthy and haven"t used antibiotics in years I am taking them. But I am a natural health practitioner and will be also using probiotics, mastic gum and allied natural health tablets made from concentrated allicin found in garlic. DGL (natural licorice) and enzymes.

Was this comment helpful?Yes
Comment from: Pegontheroad, 75 or over Female (Patient) Published: August 20

This is driving me crazy, I have been diagnosed and treated for Helicobacter pylori for 4 times in the last 10 months. The first three times I took the Prevpac treatment for 14 days. The fourth time, a physician's assistant (PA) in my primary care doctor's office prescribed 2 ciprofloxacin for 10 days. That didn't seem to work, and since I had an appointment with my gastroenterologist's PA, I talked to her about it. She gave me a 10 day supply of Pylera, which I finished 3 days ago. I don't think it did the job, as my stomach feels bloated again, which is always the signal for me that I still have H. pylori. I'm going to wait for another week to see my primary care doctor and ask for a referral to a different gastroenterologist.

Was this comment helpful?Yes


Get the latest health and medical information delivered direct to your inbox!