Sections

Medication

Medication Summary

The goals of pharmacotherapy are to eradicate the microorganism, to prevent complications, and to reduce morbidity. Triple therapies are used.

Increasing resistance to antibiotics has made alternative treatments necessary. Antibiotic resistance phenomena are now observed with a certain frequency in H pylori infections; occasionally, even after the use of different eradicating protocols, H pylori is not eradicated.^{[20, 21]}In such cases treatment with rifabutin may be indicated.

On April 1, 2020, the US Food and Drug Administration (FDA) recommended the immediate withdrawal of ranitidine from the market based on findings of unacceptable levels of N-Nitrosodimethylamine (NDMA), a possible carcinogen.^[22]In July, 2021, the original report was retracted at the request of the authors.^[23]The FDA may consider allowing ranitidine products back on the market if they are proven stable during storage and NDMA amounts do not increase to unsafe levels over time.^{[24, 25]}

Several studies are underway to elucidate the role of nanotechnology in the treatment of H pylori infection using nanoparticles synthesized with antibiotics or other agents.^{[26, 27, 28, 29]}

Class Summary

The approved antidiarrheal for this infection is bismuth subsalicylate. It has both antisecretory and antimicrobial activity.

Bismuth subsalicylate (Bismatrol, Pepto-Bismol)

View full drug information

Has cytoprotective effect on the GI mucosa, probably due to the stimulation of prostaglandin production and modulation of the immune response. In addition, it has been demonstrated that some deposits (probably bismuth salts) appear on both surfaces of the cell wall of H pylori after H pylori</i> from antral epithelium.

Class Summary

Use agents known to be effective against H pylori.

Metronidazole (Flagyl)

View full drug information

Reduced to its active form intracellularly only by anaerobic organisms, then disrupts the helical structure of DNA and inhibits bacterial nucleic acid synthesis.

Tetracycline (Sumycin)

View full drug information

Inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s).

Clarithromycin (Biaxin)

View full drug information

Inhibits bacterial growth, possibly by blocking the dissociation of peptidyl tRNA from ribosomes, causing the arrest of RNA-dependent protein synthesis.

Amoxicillin (Amoxil, Trimox)

View full drug information

Inhibits the final stage of bacterial cell wall synthesis by binding to specific PBPs on the inner part of the bacterial wall, leading to bacterial lysis.

Class Summary

Bind to proton pump of parietal cells, inhibiting the secretion of hydrogen ions into the gastric lumen. Relieve pain and heal peptic ulcers more rapidly than H2 antagonists.

Lansoprazole (Prevacid)

View full drug information

Works by inhibiting the H⁺/K⁺ -ATPase enzyme system of the gastric parietal cells.

Omeprazole (Prilosec)

View full drug information

Decreases gastric acid secretion by inhibiting parietal cell H⁺/K⁺ -ATP pump.

Class Summary

Reversible competitive blockers of histamine at H2 receptors, particularly those in the gastric parietal cells, wherein they inhibit acid secretion. H2 antagonists are highly selective, do not affect the H1 receptors, and are not anticholinergic agents. Proton pump inhibitors are usually preferred.

Ranitidine (Zantac)

View full drug information

Reduces basal and nocturnal gastric acid secretion by competitive inhibition of binding of histamine to receptors (H2 receptor) on the gastric parietal cells. Although not effective as single agents for the eradication of H pylori, appears to increase the systemic absorption of bismuth subsalicylate.

Famotidine (Pepcid)

View full drug information

Competitively inhibits histamine at H2 receptor of gastric parietal cells, resulting in reduced gastric acid secretion, gastric volume, and hydrogen ion concentrations.

Class Summary

Combinations allow ease of administration and promote enhanced patient adherence.

Amoxicillin/omeprazole/rifabutin (Talicia)

View full drug information

Combination delayed-release capsules contains amoxicillin, omeprazole, and rifabutin is administered as an every 8 h regimen. It is indicated for treatment of H pylori infection in adults.

Lansoprazole/amoxicillin/clarithromycin (Prevpac)

View full drug information

Copackaged product containing a PPI, a macrolide antimicrobial, and a penicillin class antibacterial as a twice-daily regimen. Indicated for H pylori eradication to reduce the risk of duodenal ulcer recurrence.

Omeprazole/amoxicillin/clarithromycin (Omeclamox-Pak)

View full drug information

Copackaged product containing a PPI, a macrolide antimicrobial, and a penicillin class antibacterial. It is indicated for treatment of patients with H pylori infection and duodenal ulcer disease (active or up to 1-year history) to eradicate H pylori. It is a twice-daily regimen.

Vonoprazan/amoxicillin/clarithromycin (Voquezna Triple Pak)

View full drug information

Copackaged product containing first-in-class potassium-competitive acid blocker plus a macrolide antimicrobial, and a penicillin class antibacterial. It is indicated for treatment of H pylori infection in adults.

Vonoprazan/amoxicillin (Voquezna Dual Pak)

View full drug information

Copackaged product containing first-in-class potassium-competitive acid blocker plus a penicillin class antibacterial. It is indicated for treatment of H pylori infection in adults.

Questions

[Guideline] Sugano K, Tack J, Kuipers EJ, et al, for the faculty members of Kyoto Global Consensus Conference. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015 Sep. 64(9):1353-67. [QxMD MEDLINE Link].
Mladenova I, Durazzo M. Transmission of Helicobacter pylori. Minerva Gastroenterol Dietol. 2018 Sep. 64(3):251-4. [QxMD MEDLINE Link].
Horiki N, Omata F, Uemura M, et al. Annual change of primary resistance to clarithromycin among Helicobacter pylori isolates from 1996 through 2008 in Japan. Helicobacter. 2009 Oct. 14(5):86-90. [QxMD MEDLINE Link].
Fallone CA. Epidemiology of the antibiotic resistance of Helicobacter pylori in Canada. Can J Gastroenterol. 2000 Nov. 14(10):879-82. [QxMD MEDLINE Link].
Hage N, Renshaw JG, Winkler GS, Gellert P, Stolnik S, Falcone FH. Improved expression and purification of the Helicobacter pylori adhesin BabA through the incorporation of a hexa-lysine tag. Protein Expr Purif. 2015 Feb. 106:25-30. [QxMD MEDLINE Link]. [Full Text].
Tomb JF, White O, Kerlavage AR, et al. The complete genome sequence of the gastric pathogen Helicobacter pylori. Nature. 1997 Aug 7. 388(6642):539-47. [QxMD MEDLINE Link].
Lowenthal AC, Hill M, Sycuro LK, et al. Functional analysis of the Helicobacter pylori flagellar switch proteins. J Bacteriol. 2009 Dec. 191(23):7147-56. [QxMD MEDLINE Link]. [Full Text].
Giannakis M, Chen SL, Karam SM, et al. Helicobacter pylori evolution during progression from chronic atrophic gastritis to gastric cancer and its impact on gastric stem cells. Proc Natl Acad Sci U S A. 2008 Mar. 105(11):4358-63. [QxMD MEDLINE Link].
Lehours P. Actual diagnosis of Helicobacter pylori infection. Minerva Gastroenterol Dietol. 2018 Sep. 64(3):267-79. [QxMD MEDLINE Link].
Pullen LC. Does H pylori eradication explain rising obesity? Medscape Medical News from WebMD. June 9, 2014. Available at http://www.medscape.com/viewarticle/826406. Accessed: June 19, 2014.
Lender N, Talley NJ, Enck P, et al. Review article: associations between Helicobacter pylori and obesity - an ecological study. Aliment Pharmacol Ther. 2014 Jul. 40(1):24-31. [QxMD MEDLINE Link].
[Guideline] Shah SC, Iyer PG, Moss SF. AGA clinical practice update on the management of refractory Helicobacter pylori infection: expert review. Gastroenterology. 2021 Apr. 160(5):1831-41. [QxMD MEDLINE Link]. [Full Text].
Koletzko L, Macke L, Schulz C, Malfertheiner P. Helicobacter pylori eradication in dyspepsia: New evidence for symptomatic benefit. Best Pract Res Clin Gastroenterol. 2019 Jun - Aug. 40-1:101637. [QxMD MEDLINE Link].
Luther J, Dave M, Higgins PD, Kao JY. Association between Helicobacter pylori infection and inflammatory bowel disease: a meta-analysis and systematic review of the literature. Inflamm Bowel Dis. 2010 Jun. 16(6):1077-84. [QxMD MEDLINE Link].
Jackson L, Britton J, Lewis SA, et al. A population-based epidemiologic study of Helicobacter pylori infection and its association with systemic inflammation. Helicobacter. 2009 Oct. 14(5):108-13. [QxMD MEDLINE Link].
[Guideline] Tarasconi A, Coccolini F, Biffl WL, et al. Perforated and bleeding peptic ulcer: WSES guidelines. World J Emerg Surg. 2020. 15:3. [QxMD MEDLINE Link]. [Full Text].
Hsu PI, Wu DC, Chen WC, et al. Randomized controlled trial comparing 7-day triple, 10-day sequential, and 7-day concomitant therapies for Helicobacter pylori infection. Antimicrob Agents Chemother. 2014 Oct. 58(10):5936-42. [QxMD MEDLINE Link].
Pellicano R, Zagari RM, Zhang S, Saracco GM, Moss SF. Pharmacological considerations and step-by-step proposal for the treatment of Helicobacter pylori infection in the year 2018. Minerva Gastroenterol Dietol. 2018 Sep. 64(3):310-21. [QxMD MEDLINE Link].
Papastergiou V, Georgopoulos SD, Karatapanis S. Treatment of Helicobacter pylori infection: meeting the challenge of antimicrobial resistance. World J Gastroenterol. 2014 Aug 7. 20(29):9898-911. [QxMD MEDLINE Link].
Gisbert JP, Castro-Fernandez M, Perez-Aisa A, et al. Fourth-line rescue therapy with rifabutin in patients with three Helicobacter pylori eradication failures. Aliment Pharmacol Ther. 2012 Apr. 35(8):941-7. [QxMD MEDLINE Link]. [Full Text].
Liu X, Wang H, Lv Z, et al. Rescue therapy with a proton pump inhibitor plus amoxicillin and rifabutin for Helicobacter pylori infection: a systematic review and meta-analysis. Gastroenterol Res Pract. 2015. 2015:415648. [QxMD MEDLINE Link]. [Full Text].
FDA requests removal of all ranitidine products (Zantac) from the market. FDA News Release. April 1, 2020. Available at https://www.fda.gov/news-events/press-announcements/fda-requests-removal-all-ranitidine-products-zantac-market.
Retraction to: Oral intake of ranitidine increases urinary excretion of N-nitrosodimethylamine. Carcinogenesis. 2021 Jul 16. 42(7):1008. [QxMD MEDLINE Link].
Florian J, Matta MK, DePalma R, et al. Effect of oral ranitidine on urinary excretion of N-nitrosodimethylamine (NDMA): a randomized clinical trial. JAMA. 2021 Jul 20. 326(3):240-9. [QxMD MEDLINE Link].
Douglas D. Ranitidine use does not lead to increased urinary excretion of NDMA carcinogen. Medscape News from WebMD. July 8, 2021. Available at https://www.medscape.com/viewarticle/954328. Accessed: July 20, 2021.
Safarov T, Kiran B, Bagirova M, Allahverdiyev AM, Abamor ES. An overview of nanotechnology-based treatment approaches against Helicobacter Pylori. Expert Rev Anti Infect Ther. 2019 Oct. 17(10):829-40. [QxMD MEDLINE Link].
Niaz T, Ihsan A, Abbasi R, Shabbir S, Noor T, Imran M. Chitosan-albumin based core shell-corona nano-antimicrobials to eradicate resistant gastric pathogen. Int J Biol Macromol. 2019 Oct 1. 138:1006-18. [QxMD MEDLINE Link].
Zhi X, Liu Y, Lin L, et al. Oral pH sensitive GNS@ab nanoprobes for targeted therapy of Helicobacter pylori without disturbance gut microbiome. Nanomedicine. 2019 Aug. 20:102019. [QxMD MEDLINE Link].
de Avila BE, Angsantikul P, Li J, et al. Micromotor-enabled active drug delivery for in vivo treatment of stomach infection. Nat Commun. 2017 Aug 16. 8(1):272. [QxMD MEDLINE Link]. [Full Text].
Greenberg ER, Anderson GL, Morgan DR, et al. 14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial. Lancet. 2011 Aug 6. 378(9790):507-14. [QxMD MEDLINE Link].
Liou JM, Lin JT, Chang CY, et al. Levofloxacin-based and clarithromycin-based triple therapies as first-line and second-line treatments for Helicobacter pylori infection: a randomised comparative trial with crossover design. Gut. 2010 May. 59(5):572-8. [QxMD MEDLINE Link].
Apostolopoulos P, Koumoutsos I, Ekmektzoglou K, et al. Concomitant versus sequential therapy for the treatment of Helicobacter pylori infection: a Greek randomized prospective study. Scand J Gastroenterol. 2016 Feb. 51(2):145-51. [QxMD MEDLINE Link].
Yoon H, Kim N, Lee BH, et al. Moxifloxacin-containing triple therapy as second-line treatment for Helicobacter pylori infection: effect of treatment duration and antibiotic resistance on the eradication rate. Helicobacter. 2009 Oct. 14(5):77-85. [QxMD MEDLINE Link].
Malfertheiner P, Bazzoli F, Delchier JC, et al. Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. Lancet. 2011 Mar 12. 377(9769):905-13. [QxMD MEDLINE Link].
Lee SB, Yang JW, Kim CS. The association between conjunctival MALT lymphoma and Helicobacter pylori. Br J Ophthalmol. 2008 Apr. 92(4):534-6. [QxMD MEDLINE Link].
Aanpreung P. Suggestive parameters for eradication therapy in children with Helicobacter pylori gastritis. J Med Assoc Thai. 2005 Nov. 88 Suppl 8:S21-6. [QxMD MEDLINE Link].
Adachi K, Hashimoto T, Komazawa Y, et al. Helicobacter pylori infection influences symptomatic response to anti-secretory therapy in patients with GORD--crossover comparative study with famotidine and low-dose lansoprazole. Dig Liver Dis. 2005 Jul. 37(7):485-90. [QxMD MEDLINE Link].
Alexander GA, Brawley OW. Association of Helicobacter pylori infection with gastric cancer. Mil Med. 2000 Jan. 165(1):21-7. [QxMD MEDLINE Link].
Ceponis PJ, Jones NL. Modulation of host cell signal transduction pathways by Helicobacter pylori infection. Can J Gastroenterol. 2005 Jul. 19(7):415-20. [QxMD MEDLINE Link].
Cheng TY, Lin JT, Chen LT, et al. Association of T-cell regulatory gene polymorphisms with susceptibility to gastric mucosa-associated lymphoid tissue lymphoma. J Clin Oncol. 2006 Jul 20. 24(21):3483-9. [QxMD MEDLINE Link].
Craanen ME, Blok P, Dekker W, et al. Helicobacter pylori and early gastric cancer. Gut. 1994 Oct. 35(10):1372-4. [QxMD MEDLINE Link].
Davydov L, Cheng JW. The association of infection and coronary artery disease: an update. Expert Opin Investig Drugs. 2000 Nov. 9(11):2505-17. [QxMD MEDLINE Link].
Demirel A, Oncel S, Caydere M, Dogan A, Usten H, Ongoren A. Helicobacter pylori infection in gastrectomy specimens. The Internet J of Gastro. 1999. 1(1):[Full Text].
Dunn BE, Cohen H, Blaser MJ. Helicobacter pylori. Clin Microbiol Rev. 1997 Oct. 10(4):720-41. [QxMD MEDLINE Link].
Eaton KA, Benson LH, Haeger J, et al. Role of transcription factor T-bet expression by CD4+ cells in gastritis due to Helicobacter pylori in mice. Infect Immun. 2006 Aug. 74(8):4673-84. [QxMD MEDLINE Link].
El-Omar EM, Carrington M, Chow WH, et al. Interleukin-1 polymorphisms associated with increased risk of gastric cancer. Nature. 2000 Mar 23. 404(6776):398-402. [QxMD MEDLINE Link].
Ercan I, Cakir BO, Uzel TS, et al. The role of gastric Helicobacter pylori infection in laryngopharyngeal reflux disease. Otolaryngol Head Neck Surg. 2006 Jul. 135(1):52-5. [QxMD MEDLINE Link].
Fiorini G, Vakil N, Zullo A, et al. Culture-based selection therapy for patients who did not respond to previous treatment for Helicobacter pylori infection. Clin Gastroenterol Hepatol. 2013 May. 11(5):507-10. [QxMD MEDLINE Link].
Fischbach W. Primary gastric lymphoma of MALT: considerations of pathogenesis, diagnosis and therapy. Can J Gastroenterol. 2000 Nov. 14 Suppl D:44D-50D. [QxMD MEDLINE Link].
Fock KM, Katelaris P, Sugano K, et al. Second Asia-Pacific Consensus Guidelines for Helicobacter pylori infection. J Gastroenterol Hepatol. 2009 Oct. 24(10):1587-600. [QxMD MEDLINE Link].
Garcia-Altes A, Rota R, Barenys M, et al. Cost-effectiveness of a 'score and scope' strategy for the management of dyspepsia. Eur J Gastroenterol Hepatol. 2005 Jul. 17(7):709-19. [QxMD MEDLINE Link].
Gatopoulou A, Mimidis K, Giatromanolaki A, et al. Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease. World J Gastroenterol. 2004 Apr 15. 10(8):1180-2. [QxMD MEDLINE Link].
Graham DY. Therapy of Helicobacter pylori: current status and issues. Gastroenterology. 2000 Feb. 118(2 Suppl 1):S2-8. [QxMD MEDLINE Link].
Graham DY, Lew GM, Lechago J. Antral G-cell and D-cell numbers in Helicobacter pylori infection: effect of H. pylori eradication. Gastroenterology. 1993 Jun. 104(6):1655-60. [QxMD MEDLINE Link].
Graham DY, Lew GM, Malaty HM, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology. 1992 Feb. 102(2):493-6. [QxMD MEDLINE Link].
Graham DY, Malaty HM, Evans DG, et al. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology. 1991 Jun. 100(6):1495-501. [QxMD MEDLINE Link].
[Guideline] Howden CW, Hunt RH. Guidelines for the management of Helicobacter pylori infection. Ad Hoc Committee on Practice Parameters of the American College of Gastroenterology. Am J Gastroenterol. 1998 Dec. 93(12):2330-8. [QxMD MEDLINE Link].
Jia CL, Jiang GS, Li CH, Li CR. Effect of dental plaque control on infection of Helicobacter pylori in gastric mucosa. J Periodontol. 2009 Oct. 80(10):1606-9. [QxMD MEDLINE Link].
Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006 Jul. 19(3):449-90. [QxMD MEDLINE Link].
Leinonen M, Saikku P. Infections and atherosclerosis. Scand Cardiovasc J. 2000. 34(1):12-20. [QxMD MEDLINE Link].
Lopes AI, Victorino RM, Palha AM, et al. Mucosal lymphocyte subsets and HLA-DR antigen expression in paediatric Helicobacter pylori-associated gastritis. Clin Exp Immunol. 2006 Jul. 145(1):13-20. [QxMD MEDLINE Link].
Mueller A, Sayi A, Hitzler I. Protective and pathogenic functions of T-cells are inseparable during the Helicobacter-host interaction. Discov Med. 2009 Aug. 8(41):68-73. [QxMD MEDLINE Link].
Nakajima S, Krishnan B, Ota H, et al. Mast cell involvement in gastritis with or without Helicobacter pylori infection. Gastroenterology. 1997 Sep. 113(3):746-54. [QxMD MEDLINE Link].
Padol S, Yuan Y, Thabane M, et al. The effect of CYP2C19 polymorphisms on H. pylori eradication rate in dual and triple first-line PPI therapies: a meta-analysis. Am J Gastroenterol. 2006 Jul. 101(7):1467-75. [QxMD MEDLINE Link].
Peach HG, Barnett NE. Determinants of basal plasma gastrin levels in the general population. J Gastroenterol Hepatol. 2000 Nov. 15(11):1267-71. [QxMD MEDLINE Link].
Pratt JS, Sachen KL, Wood HD, et al. Modulation of host immune responses by the cytolethal distending toxin of Helicobacter hepaticus. Infect Immun. 2006 Aug. 74(8):4496-504. [QxMD MEDLINE Link].
Reyrat JM, Rappuoli R, Telford JL. A structural overview of the Helicobacter cytotoxin. Int J Med Microbiol. 2000 Oct. 290(4-5):375-9. [QxMD MEDLINE Link].
Rodrigues MN, Queiroz DM, Bezerra Filho JG, et al. Prevalence of Helicobacter pylori infection in children from an urban community in north-east Brazil and risk factors for infection. Eur J Gastroenterol Hepatol. 2004 Feb. 16(2):201-5. [QxMD MEDLINE Link].
Santacroce L, Bufo P, Latorre V, et al. [Role of mast cells in the physiopathology of gastric lesions caused by Helicobacter pylori]. Chir Ital. 2000 Sep-Oct. 52(5):527-31. [QxMD MEDLINE Link].
Smoot DT, Mobley HL, Chippendale GR, et al. Helicobacter pylori urease activity is toxic to human gastric epithelial cells. Infect Immun. 1990 Jun. 58(6):1992-4. [QxMD MEDLINE Link].
Stahler FN, Odenbreit S, Haas R, et al. The novel Helicobacter pylori CznABC metal efflux pump is required for cadmium, zinc, and nickel resistance, urease modulation, and gastric colonization. Infect Immun. 2006 Jul. 74(7):3845-52. [QxMD MEDLINE Link].
Tsai CJ, Perry S, Sanchez L, et al. Helicobacter pylori infection in different generations of Hispanics in the San Francisco Bay Area. Am J Epidemiol. 2005 Aug 15. 162(4):351-7. [QxMD MEDLINE Link].
Tytgat GN. Review article: Helicobacter pylori: where are we and where are we going?. Aliment Pharmacol Ther. 2000 Oct. 14 Suppl 3:55-8. [QxMD MEDLINE Link].
Warren JR, Marshall B. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet. 1983 Jun 4. 1(8336):1273-5. [QxMD MEDLINE Link].
Vaira D, Gatta L, Ricci C, et al. Peptic ulcer and Helicobacter pylori: update on testing and treatment. Postgrad Med. 2005 Jun. 117(6):17-22, 46. [QxMD MEDLINE Link].
Wang X, Wattiez R, Paggliacia C, et al. Membrane topology of VacA cytotoxin from H. pylori. FEBS Lett. 2000 Sep 15. 481(2):96-100. [QxMD MEDLINE Link].
Watts TL. Smoking, Helicobacter pylori, and periodontitis. BMJ. 2006 Jun 24. 332(7556):1513. [QxMD MEDLINE Link].
Wotherspoon AC. A critical review of the effect of Helicobacter pylori eradication on gastric MALT lymphoma. Curr Gastroenterol Rep. 2000 Dec. 2(6):494-8. [QxMD MEDLINE Link].
Chao CY, Wang CH, Che YJ, Kao CY, Wu JJ, Lee GB. An integrated microfluidic system for diagnosis of the resistance of Helicobacter pylori to quinolone-based antibiotics. Biosens Bioelectron. 2016 Apr 15. 78:281-9. [QxMD MEDLINE Link].
Lee YC, Chiang TH, Liou JM, Chen HH, Wu MS, Graham DY. Mass eradication of Helicobacter pylori to prevent gastric cancer: theoretical and practical considerations. Gut Liver. 2016 Jan 23. 10(1):12-26. [QxMD MEDLINE Link].
Kono Y, Okada H, Takenaka R, et al. Does Helicobacter pylori exacerbate gastric mucosal injury in users of nonsteroidal anti-inflammatory drugs? A multicenter, retrospective, case-control study. Gut Liver. 2016 Jan 23. 10(1):69-75. [QxMD MEDLINE Link].
Isaeva GS, Fagoonee S. Biological properties and pathogenicity factors of Helicobacter pylori. Minerva Gastroenterol Dietol. 2018 Sep. 64(3):255-66. [QxMD MEDLINE Link].

Media Gallery

Helicobacter Pylori Infection. This image shows an antral gland of the stomach with a large Giemsa-stained colony of Helicobacter pylori in the lumen (arrow) at 250X power. Courtesy of Pantaleo Bufo, University of Foggia, Italy.
Helicobacter Pylori Infection. A lamina propria of the stomach is shown with two mast cells overlapping each other. Note the upper part reveals the degranulating process with the release of granules of inflammation mediators (Giemsa staining, 250X). Courtesy of Pantaleo Bufo, University of Foggia, Italy.
Helicobacter Pylori Infection. A transverse section of the gastric lamina propria is shown. In the lower part, an antral gland of the stomach is present with some Helicobacter pylori in the lumen (red-blue arrow). In the upper part, a mast cell (yellow arrow) is present (Giemsa staining, 250X). Courtesy of Pantaleo Bufo, University of Foggia, Italy.
Helicobacter Pylori Infection. An antral gland of the stomach is shown with a large colony of Helicobacter pylori in the lumen (Giemsa staining, 425X). Courtesy of Pantaleo Bufo, University of Foggia, Italy.

of 4

Helicobacter Pylori Infection Medication

Medication Summary

Antidiarrheals

Class Summary

Bismuth subsalicylate (Bismatrol, Pepto-Bismol)

Bismuth subsalicylate (Bismatrol, Pepto-Bismol)

Antibiotics

Class Summary

Metronidazole (Flagyl)

Metronidazole (Flagyl)

Tetracycline (Sumycin)

Tetracycline (Sumycin)

Clarithromycin (Biaxin)

Clarithromycin (Biaxin)

Amoxicillin (Amoxil, Trimox)

Amoxicillin (Amoxil, Trimox)

Proton pump inhibitors

Class Summary

Lansoprazole (Prevacid)

Lansoprazole (Prevacid)

Omeprazole (Prilosec)

Omeprazole (Prilosec)

H2 receptor blockers

Class Summary

Ranitidine (Zantac)

Ranitidine (Zantac)

Famotidine (Pepcid)

Famotidine (Pepcid)

Combination Products

Class Summary

Amoxicillin/omeprazole/rifabutin (Talicia)

Amoxicillin/omeprazole/rifabutin (Talicia)

Lansoprazole/amoxicillin/clarithromycin (Prevpac)

Lansoprazole/amoxicillin/clarithromycin (Prevpac)

Omeprazole/amoxicillin/clarithromycin (Omeclamox-Pak)

Omeprazole/amoxicillin/clarithromycin (Omeclamox-Pak)

Vonoprazan/amoxicillin/clarithromycin (Voquezna Triple Pak)

Vonoprazan/amoxicillin/clarithromycin (Voquezna Triple Pak)

Vonoprazan/amoxicillin (Voquezna Dual Pak)

Vonoprazan/amoxicillin (Voquezna Dual Pak)

Helicobacter Pylori Infection Medication

Medication Summary

Antidiarrheals

Class Summary

Bismuth subsalicylate (Bismatrol, Pepto-Bismol)

Antibiotics

Class Summary

Metronidazole (Flagyl)

Tetracycline (Sumycin)

Clarithromycin (Biaxin)

Amoxicillin (Amoxil, Trimox)

Proton pump inhibitors

Class Summary

Lansoprazole (Prevacid)

Omeprazole (Prilosec)

H2 receptor blockers

Class Summary

Ranitidine (Zantac)

Famotidine (Pepcid)

Combination Products

Class Summary

Amoxicillin/omeprazole/rifabutin (Talicia)

Lansoprazole/amoxicillin/clarithromycin (Prevpac)

Omeprazole/amoxicillin/clarithromycin (Omeclamox-Pak)

Vonoprazan/amoxicillin/clarithromycin (Voquezna Triple Pak)

Vonoprazan/amoxicillin (Voquezna Dual Pak)

References

Tables

Contributor Information and Disclosures

What would you like to print?