The Helicobacter Foundation

The table below was developed by the following authors

Barry J. Marshall M.D.

Loren Laine M.D

Dr. Aruni Mendis PhD, Dip.Imp.Coll.

The data was comparable with that presented at the American Gastrointestinal Association conference held in Washington D.C. in May 1997. Most data is still valid as of July 2006.

Please Note that 20mg omeprazole and 30 mg lansoprazole are equivalent in most treatments.



Conventional First-Line Triple Therapies - Twice-Daily PPI-Based Triple Therapies

Cure rate 90%: with 2 weeks treatment in the US; 1 week treatment outside the US

  • Omeprazole 20 mg bid or Lansoprazole 30 mg bid
  • Clarithromycin 500 mg bid
  • Metronidazole 250 mg qid (or tid)
  • Amoxicillin 1 g bid or Metronidazole 500 mg bid if Amoxycillin intolerant


Traditional Bismuth Based Triple Therapy

Cure rate 80% with 2 weeks Treatment (USA) ;
Cure rate outside U.S.A.: 90% with 1-2 weeks Treatment

  • Bismuth subsalicylate (Pepto-Bismol) 2 (How many mg???) tablets qid in U.S.
    OR
  • Colloidal bismuth subcitrate [De-Nol]** 120mg qid outside U.S.
    • Tetracycline 500 mg qid
    • Metronidazole 400 mg qid
    • Proton Pump Inhibitor (20mg Omeprazole bid or 30 mg lansoprazole. bid)

    **De-Nol is Available in Australia Under the TGA’s Special Access Scheme (SAS) Contact Tri-Med Distributors P/L; Email sales@trimed.com.au ; Ph. +61 8 9388 1444


    Furazolidone & Bismuth Based (Second Line) Quadruple Therapies : Cure Rate >92%  Duration of Treatment 14 day

    • Furazolidone 200mg bid
    • Colloidal Bismuth Subcitrate (De-Nol) 120mg qid
    • Amoxicillin 1000mg bid
    • 20mg Omeprazole bid OR 30 mg lansoprazole. bid


    Third-Line Quadruple “Salvage Therapy” ( Marshall Therapy)

    • Cprofloxacin 500mg bid
    • Rifabutin** 150mg bid
    • Omeprazole 40mg tds (six times the normal dose)
    • Amoxycillin 1000mg tds

    ** Rifabutin is only available through a Hospital Pharmacy

    Other Triple Therapies - Twice-Daily RBC-Based Triple Therapy

    Cure rate 90% with 2 weeks treatment.
    • Ranitidine bismuth citrate (RBC)** 400 mg bid
    • Clarithromycin 500 mg bid
    • Amoxicillin 1 g bid (or metronidazole 500 mg bid if Amoxicillin intolerant)

    **RBC has been de-listed in Australlia; However, De-Nol can be substituted for RBC. De-Nol is Available in Australia Under the TGA’s Special Access Scheme (SAS) Contact Tri-Med Distributors P/L; Email:sales@trimed.com.au ; Ph. +61 8 9388 1444

    Other US-FDA-Approved Dual Therapies

    Cure rate 70% at 2 weeks
    • Omeprazole 40 mg qid
    • Clarithromycin 500 mg tid

    Cure rate 80% at 2 weeks
    • Ranitidine bismuth citrate 400 mg bid
    • Clarithromycin 500 mg tid


    Common Trade Names for drugs used

    Detailed drug information

    Biaxin, Klacid clarithromycin Abbott
    Flagyl metronidazole Generic
    Tritec ranitidine bismuth citrate Glaxo-Wellcome
    Prilosec, Losec omeprazole Astra/Astra-Merck
    Prevacid lansoprazole bbb

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