Helicobacter pylori - Revision history

Danbot: Add Metronidazole, Amoxicillin, Clarithromycin AntibioticDose entries

2026-03-20T10:58:54Z

Add Metronidazole, Amoxicillin, Clarithromycin AntibioticDose entries

← Revisión anterior		Revisión del 10:58 20 mar 2026
Línea 1:		Línea 1:
	<languages/>		<languages/>
	~~<translate>~~

	==Background==		==Background==

	*''H. pylori'' is a gram negative bacteria that causes [[~~Special:MyLanguage/~~gastritis\|gastritis]], [[~~Special:MyLanguage/~~peptic ulcer disease\|peptic ulcer disease]], and gastric adenocarcinoma.		*''H. pylori'' is a gram negative bacteria that causes [[gastritis\|gastritis]], [[peptic ulcer disease\|peptic ulcer disease]], and gastric adenocarcinoma.


	==Clinical Features==		==Clinical Features==

	*[[~~Special:MyLanguage/~~Epigastric abdominal pain\|Epigastric abdominal pain]]		*[[Epigastric abdominal pain\|Epigastric abdominal pain]]
	*[[~~Special:MyLanguage/~~Gastroesophageal Reflux Disease\|Gastroesophageal Reflux Disease]]		*[[Gastroesophageal Reflux Disease\|Gastroesophageal Reflux Disease]]


	==Differential Diagnosis==		==Differential Diagnosis==

	~~</translate>~~
	{{Abdominal Pain DDX Epigastric}}		{{Abdominal Pain DDX Epigastric}}
	~~<translate>~~


Línea 36:		Línea 36:
	===Triple Therapy===		===Triple Therapy===

	*[[~~Special:MyLanguage/~~PPI\|PPI]] plus [[~~Special:MyLanguage/~~clarithromycin\|clarithromycin]] 500mg twice daily, and [[~~Special:MyLanguage/~~amoxicillin\|amoxicillin]] 1000mg twice daily for 10-14 days		*[[PPI\|PPI]] plus [[clarithromycin\|clarithromycin]] 500mg twice daily, and [[amoxicillin\|amoxicillin]] 1000mg twice daily for 10-14 days
	*If penicillin allergic: PPI plus [[~~Special:MyLanguage/~~clarithromycin\|clarithromycin]] 500mg twice daily, [[~~Special:MyLanguage/~~metronidazole\|metronidazole]] 500mg twice daily for 10-14 days		*If penicillin allergic: PPI plus [[clarithromycin\|clarithromycin]] 500mg twice daily, [[metronidazole\|metronidazole]] 500mg twice daily for 10-14 days
	*Concomitant therapy adds [[~~Special:MyLanguage/~~metronidazole\|metronidazole]] 500 mg BID to triple therapy for 10-14 days		*Concomitant therapy adds [[metronidazole\|metronidazole]] 500 mg BID to triple therapy for 10-14 days

	===[[~~Special:MyLanguage/~~Bismuth subsalicylate\|Bismuth]] Quadruple Therapy===		===[[Bismuth subsalicylate\|Bismuth]] Quadruple Therapy===

	*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>		*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>
	*Bismuth quadruple therapy for 10 days:		*Bismuth quadruple therapy for 10 days:
	**[[~~Special:MyLanguage/~~Bismuth subsalicylate\|Bismuth subsalicylate]] 300 mg QID		**[[Bismuth subsalicylate\|Bismuth subsalicylate]] 300 mg QID
	**[[~~Special:MyLanguage/~~Lansoprazole\|Lansoprazole]] 30 mg BID		**[[Lansoprazole\|Lansoprazole]] 30 mg BID
	**[[~~Special:MyLanguage/~~Tetracycline\|Tetracycline]] 500 mg QID		**[[Tetracycline\|Tetracycline]] 500 mg QID
	**[[~~Special:MyLanguage/~~Metronidazole\|Metronidazole]] 500 mg TID		**[[Metronidazole\|Metronidazole]] 500 mg TID



			===Antibiotic Dosing===
			====Adult====
			*{{AntibioticDose\|drug=Metronidazole\|dose=250-375mg PO q6h x 10-14 days (in combination)\|context=H. pylori\|disease=Helicobacter pylori\|population=Adult}}
			*{{AntibioticDose\|drug=Clarithromycin\|dose=triple treatment: 500mg PO q12hr x 7-14d; dual treatment: 500mg PO q8h x 14d (give with Omeprazole 40mg QD x 14d)\|context=H. pylori infection\|disease=Helicobacter pylori\|population=Adult}}
			====Pediatric====
			*{{AntibioticDose\|drug=Amoxicillin\|dose=50mg/kg/day PO divided BID x 7-14 days; Max: 2000mg/day\|context=H. pylori\|disease=Helicobacter pylori\|population=Pediatric}}
			*{{AntibioticDose\|drug=Clarithromycin\|dose=20mg/kg/day PO divided BID x 7-14d; max 1000mg/day\|context=H. pylori infection\|disease=Helicobacter pylori\|population=Pediatric}}

	==Disposition==		==Disposition==
Línea 57:		Línea 66:
	==See Also==		==See Also==

	*[[~~Special:MyLanguage/~~Peptic Ulcer Disease\|Peptic Ulcer Disease]]		*[[Peptic Ulcer Disease\|Peptic Ulcer Disease]]
	*[[~~Special:MyLanguage/~~Gastroesophageal Reflux Disease\|Gastroesophageal Reflux Disease]]		*[[Gastroesophageal Reflux Disease\|Gastroesophageal Reflux Disease]]


Línea 70:		Línea 79:
	[[Category:GI]]		[[Category:GI]]
	[[Category:ID]]		[[Category:ID]]
	~~</translate>~~

Ostermayer: Prepared the page for translation

2026-01-04T22:57:40Z

Prepared the page for translation

← Revisión anterior		Revisión del 22:57 4 ene 2026
Línea 1:		Línea 1:
			<languages/>
			<translate>

	==Background==		==Background==
	*''H. pylori'' is a gram negative bacteria that causes [[gastritis]], [[peptic ulcer disease]], and gastric adenocarcinoma.
			*''H. pylori'' is a gram negative bacteria that causes [[Special:MyLanguage/gastritis\|gastritis]], [[Special:MyLanguage/peptic ulcer disease\|peptic ulcer disease]], and gastric adenocarcinoma.


	==Clinical Features==		==Clinical Features==
	*[[Epigastric abdominal pain]]
	*[[Gastroesophageal Reflux Disease]]		*[[Special:MyLanguage/Epigastric abdominal pain\|Epigastric abdominal pain]]
			*[[Special:MyLanguage/Gastroesophageal Reflux Disease\|Gastroesophageal Reflux Disease]]


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Abdominal Pain DDX Epigastric}}		{{Abdominal Pain DDX Epigastric}}
			<translate>


	==Evaluation==		==Evaluation==

	*Non-invasive Testing		*Non-invasive Testing
	**Urea Breath Testing		**Urea Breath Testing
Línea 15:		Línea 27:
	**Stool Antigen Assay		**Stool Antigen Assay
	*Invasive Testing - Endoscopy		*Invasive Testing - Endoscopy


	==Management==		==Management==

	*Though feasible in the ED<ref>Meltzer AC, et al. Rapid (13) C urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. WJ Emerg Med. 2013; 14:278-282.</ref>, antibiotic therapy is typically not offered		*Though feasible in the ED<ref>Meltzer AC, et al. Rapid (13) C urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. WJ Emerg Med. 2013; 14:278-282.</ref>, antibiotic therapy is typically not offered
	*Beware of other causes of abdominal pain despite positive testing		*Beware of other causes of abdominal pain despite positive testing

	===Triple Therapy===		===Triple Therapy===
	*[[PPI]] plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*[[Special:MyLanguage/PPI\|PPI]] plus [[Special:MyLanguage/clarithromycin\|clarithromycin]] 500mg twice daily, and [[Special:MyLanguage/amoxicillin\|amoxicillin]] 1000mg twice daily for 10-14 days
	*Concomitant therapy adds [[metronidazole]] 500 mg BID to triple therapy for 10-14 days		*If penicillin allergic: PPI plus [[Special:MyLanguage/clarithromycin\|clarithromycin]] 500mg twice daily, [[Special:MyLanguage/metronidazole\|metronidazole]] 500mg twice daily for 10-14 days
	===[[Bismuth subsalicylate\|Bismuth]] Quadruple Therapy===		*Concomitant therapy adds [[Special:MyLanguage/metronidazole\|metronidazole]] 500 mg BID to triple therapy for 10-14 days

			===[[Special:MyLanguage/Bismuth subsalicylate\|Bismuth]] Quadruple Therapy===

	*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>		*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>
	*Bismuth quadruple therapy for 10 days:		*Bismuth quadruple therapy for 10 days:
	**[[Bismuth subsalicylate]] 300 mg QID		**[[Special:MyLanguage/Bismuth subsalicylate\|Bismuth subsalicylate]] 300 mg QID
	**[[Lansoprazole]] 30 mg BID		**[[Special:MyLanguage/Lansoprazole\|Lansoprazole]] 30 mg BID
	**[[Tetracycline]] 500 mg QID		**[[Special:MyLanguage/Tetracycline\|Tetracycline]] 500 mg QID
	**[[Metronidazole]] 500 mg TID		**[[Special:MyLanguage/Metronidazole\|Metronidazole]] 500 mg TID


	==Disposition==		==Disposition==

	*Discharge with GI outpatient follow-up		*Discharge with GI outpatient follow-up


	==See Also==		==See Also==
	*[[Peptic Ulcer Disease]]
	*[[Gastroesophageal Reflux Disease]]		*[[Special:MyLanguage/Peptic Ulcer Disease\|Peptic Ulcer Disease]]
			*[[Special:MyLanguage/Gastroesophageal Reflux Disease\|Gastroesophageal Reflux Disease]]


	==External Links==		==External Links==


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
	[[Category:ID]]		[[Category:ID]]
			</translate>

ClaireLewis at 15:12, 14 September 2019

2019-09-14T15:12:05Z

← Revisión anterior		Revisión del 15:12 14 sep 2019
Línea 1:		Línea 1:
	==Background==		==Background==
	*''H. pylori'' is a gram negative bacteria that causes gastritis, peptic ulcer disease, and gastric adenocarcinoma.		*''H. pylori'' is a gram negative bacteria that causes [[gastritis]], [[peptic ulcer disease]], and gastric adenocarcinoma.

	==Clinical Features==		==Clinical Features==
	*Epigastric abdominal pain		*[[Epigastric abdominal pain]]
	*[[Gastroesophageal Reflux Disease]]		*[[Gastroesophageal Reflux Disease]]

Línea 20:		Línea 20:
	*Beware of other causes of abdominal pain despite positive testing		*Beware of other causes of abdominal pain despite positive testing
	===Triple Therapy===		===Triple Therapy===
	*PPI plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days		*[[PPI]] plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days
	*Concomitant therapy adds [[metronidazole]] 500 mg BID to triple therapy for 10-14 days		*Concomitant therapy adds [[metronidazole]] 500 mg BID to triple therapy for 10-14 days
	===Bismuth Quadruple Therapy===		===[[Bismuth subsalicylate\|Bismuth]] Quadruple Therapy===
	*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>		*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>
	*Bismuth quadruple therapy for 10 days:		*Bismuth quadruple therapy for 10 days:
	**Bismuth 300 mg QID		**[[Bismuth subsalicylate]] 300 mg QID
	**Lansoprazole 30 mg BID		**[[Lansoprazole]] 30 mg BID
	**Tetracycline 500 mg QID		**[[Tetracycline]] 500 mg QID
	**Metronidazole 500 mg TID		**[[Metronidazole]] 500 mg TID

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - "metronidazole " to "metronidazole "

2019-07-04T03:47:36Z

Text replacement - "metronidazole " to "metronidazole "

← Revisión anterior		Revisión del 03:47 4 jul 2019
Línea 22:		Línea 22:
	*PPI plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days		*PPI plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days
	*Concomitant therapy adds metronidazole 500 mg BID to triple therapy for 10-14 days		*Concomitant therapy adds [[metronidazole]] 500 mg BID to triple therapy for 10-14 days
	===Bismuth Quadruple Therapy===		===Bismuth Quadruple Therapy===
	*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>		*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>

Kxl328: /* Management */

2016-10-22T22:22:56Z

Management

← Revisión anterior		Revisión del 22:22 22 oct 2016
Línea 22:		Línea 22:
	*PPI plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days		*PPI plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days
			*Concomitant therapy adds metronidazole 500 mg BID to triple therapy for 10-14 days
			===Bismuth Quadruple Therapy===
			*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>
			*Bismuth quadruple therapy for 10 days:
			**Bismuth 300 mg QID
			**Lansoprazole 30 mg BID
			**Tetracycline 500 mg QID
			**Metronidazole 500 mg TID

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - " clarithromycin " to " clarithromycin "

2016-09-08T15:23:59Z

Text replacement - " clarithromycin " to " clarithromycin "

← Revisión anterior		Revisión del 15:23 8 sep 2016
Línea 20:		Línea 20:
	*Beware of other causes of abdominal pain despite positive testing		*Beware of other causes of abdominal pain despite positive testing
	===Triple Therapy===		===Triple Therapy===
	*PPI plus clarithromycin 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days		*PPI plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If penicillin allergic: PPI plus clarithromycin 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - "PCN " to "penicillin "

2016-09-08T15:14:35Z

Text replacement - "PCN " to "penicillin "

← Revisión anterior		Revisión del 15:14 8 sep 2016
Línea 21:		Línea 21:
	===Triple Therapy===		===Triple Therapy===
	*PPI plus clarithromycin 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days		*PPI plus clarithromycin 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If ~~PCN~~ allergic: PPI plus clarithromycin 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*If penicillin allergic: PPI plus clarithromycin 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - " amoxicillin " to " amoxicillin "

2016-09-08T10:16:51Z

Text replacement - " amoxicillin " to " amoxicillin "

← Revisión anterior		Revisión del 10:16 8 sep 2016
Línea 20:		Línea 20:
	*Beware of other causes of abdominal pain despite positive testing		*Beware of other causes of abdominal pain despite positive testing
	===Triple Therapy===		===Triple Therapy===
	*PPI plus clarithromycin 500mg twice daily, and amoxicillin 1000mg twice daily for 10-14 days		*PPI plus clarithromycin 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
	*If PCN allergic: PPI plus clarithromycin 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days		*If PCN allergic: PPI plus clarithromycin 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days

Rossdonaldson1: Text replacement - " metronidazole " to " metronidazole "

2016-09-08T10:15:07Z

Text replacement - " metronidazole " to " metronidazole "

← Revisión anterior		Revisión del 10:15 8 sep 2016
Línea 21:		Línea 21:
	===Triple Therapy===		===Triple Therapy===
	*PPI plus clarithromycin 500mg twice daily, and amoxicillin 1000mg twice daily for 10-14 days		*PPI plus clarithromycin 500mg twice daily, and amoxicillin 1000mg twice daily for 10-14 days
	*If PCN allergic: PPI plus clarithromycin 500mg twice daily, metronidazole 500mg twice daily for 10-14 days		*If PCN allergic: PPI plus clarithromycin 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days

	==Disposition==		==Disposition==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T11:23:12Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 11:23 23 jul 2016
Línea 9:		Línea 9:
	{{Abdominal Pain DDX Epigastric}}		{{Abdominal Pain DDX Epigastric}}

	==~~Diagnosis~~==		==Evaluation==
	*Non-invasive Testing		*Non-invasive Testing
	**Urea Breath Testing		**Urea Breath Testing