A 48-year-old woman has been diagnosed with a duodenal ulcer that is complicated by H. pylori infection. A suitable therapeutic regimen for this patient would be
a single antibiotic.
a single antibiotic plus a proton pump inhibitor.
misoprostol plus a proton pump inhibitor.
an H2 receptor antagonist.
2 antibiotics plus a proton pump inhibitor.
Answer is e. H. pylori infection is effectively eradicated with an acid-suppressing drug plus at least 2 antibiotics (see Table 32-1). A single antibiotic or acid-suppressing drug alone is not effective in eradicating H. pylori.
Triple therapy × 14 days: Proton pump inhibitor + clarithromycin 500 mg plus metronidazole 500 mg or amoxicillin 1 g twice a day (tetracycline 500 mg can be substituted for amoxicillin or metronidazole)
|Proton pump inhibitors:||H2 receptor antagonists:|
|Omeprazole: 20 mg||Cimetidine: 400 mg|
|Lansoprazole: 30 mg||Famotidine: 20 mg|
|Rabeprazole: 20 mg||Nizatidine: 150 mg|
|Pantoprazole: 40 mg||Ranitidine: 150 mg|
|Esomeprazole: 40 mg|