Chronic Gastritis Medication

Updated: Dec 20, 2017
  • Author: Akiva J Marcus, MD, PhD; Chief Editor: BS Anand, MD  more...
  • Print
Medication

Medication Summary

The most widely used and most efficient regimens for eradicating Helicobacter pylori are triple therapies (recommended as first-line treatment) and quadruple therapies (recommended as second-line treatment).

Next:

Antibiotics

Class Summary

The antibiotics selected have antimicrobial activity against most H pylori strains. Rare resistant strains have been reported.

Amoxicillin (Moxatag)

Amoxicillin is an acid-stable semisynthetic penicillin. Its antimicrobial activity is pH-dependent, with the minimal inhibitory concentration (MIC) decreasing as the pH increases.

Clarithromycin (Biaxin)

Clarithromycin is a macrolide that binds to bacterial ribosomes and disrupts protein synthesis, leading to bacterial cell death. It is the most acid-stable of the macrolides and has the lowest MIC. Its major metabolite also is active against H pylori.

Tetracycline

Tetracycline treats infections with gram-positive and gram-negative organisms, as well as mycoplasmal, chlamydial, and rickettsial infections. It inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s). Its potency is affected in solutions whose pH is less than 2, and it is rapidly destroyed by alkali hydroxide solutions.

Metronidazole (Flagyl)

Metronidazole is an imidazole ring-based antibiotic that is active against various anaerobic bacteria and protozoa. It is used in combination with other antimicrobial agents. Because the activity of metronidazole is pH-independent, it is theoretically an ideal drug for the gastric environment.

Previous
Next:

Proton Pump Inhibitors

Class Summary

A substituted benzimidazole (a compound that inhibits gastric acid secretion) is the active ingredient of proton pump inhibitors (PPIs). PPIs do not exhibit anticholinergic or H2 antagonistic activities but suppress acid secretion by specific inhibition of the H+/K+ –adenosine triphosphatase (ATPase) enzyme system on the secretory surface of parietal cells.

Omeprazole (Prilosec)

Omeprazole decreases gastric acid secretion by inhibiting the parietal cell H+/K+-adenosine triphosphate (ATP) pump at the secretory surface of gastric parietal cells.

Lansoprazole (Prevacid)

Lansoprazole decreases gastric acid secretion by inhibiting the parietal cell H+/K+-ATP pump at the secretory surface of gastric parietal cells.

Rabeprazole (AcipHex)

Rabeprazole decreases gastric acid secretion by inhibiting the parietal cell H+/K+-ATP pump at the secretory surface of gastric parietal cells.

Pantoprazole (Protonix)

Pantoprazole decreases gastric acid secretion by inhibiting the parietal cell H+/K+-ATP pump at the secretory surface of gastric parietal cells.

Esomeprazole (Nexium)

Esomeprazole inhibits gastric acid secretion by inhibiting the H+/K+-ATPase enzyme system at the secretory surface of gastric parietal cells.

Previous
Next:

Gastrointestinal Agents, Other

Class Summary

The components of bismuth-containing therapies have demonstrated in vitro activity against most susceptible strains of H pylori.

Bismuth subsalicylate (Pepto-Bismol, Bismatrol, Diotame)

This agent exerts antisecretory and antimicrobial effects. It may also provide anti-inflammatory action.

Previous