Helicobacter pylori

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC). See guidance on dosing in children for quick reference dosage/weight guide. Refer to drug interactions table for detailed drug interactions for all antimicrobials. Note extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.

Note additional warnings for clarithromycin and fluoroquinolones

Eradication of Helicobacter pylori

  • Eradication is beneficial in duodenal ulcer, gastric ulcer and low grade MALTOMA, but NOT in GORD.A In non-ulcer dysepsia, 8% of patients benefit.
  • Triple treatment attains >85% eradication.A+
  • Do not use clarithromycin or metronidazole if used in the past year for any infection.A+

Managing Symptomatic Relapse

  • Duodenal ulcer/Gastric ulcer: Retest for helicobacter if symptomatic
  • Non-ulcer dyspepsia: Do not retest, treat as functional dyspepsia.
  • In treatment failure consider endoscopy for culture & susceptibility.C Use 14 days BD PPI plus 2 antibiotics. Consider adding bismuth salt.

Treatment

Helicobacter pylori treatment table 2019

See guidance on dosing in children for quick reference dosage/weight guide.

Patient Information

We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

Reviewed June 2016

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