There has been an increase in H.pylori antibiotic resistance throughout Europe
Presently the leading triple combination therapy in UK is a 2 week course of Omeprazole 40mg bd + Clarithromycin 500mg bd + Metronidazole 400mg bd
With resistant cases quadruple therapy can be considered using 10-14 days of;-
a) Omeprazole 20mg qds + Tetracycline 500mg qds + Metronidazole 250mg qds + Bismuth Subsalicylate 524mg qds
b) Omeprazole 40mg bd + Tetracycline 1g bd + Furazolidone 200mg bd + Tripotassium Dicitratobismuthate 240mg bd
Faecal H.pylori antigen screen should be repeated 3months after treatment to ensure successful eradication