BQT: bismuth quadruple therapy; H. pylori: Helicobacter pylori; PPI: proton pump inhibitor.
* All patients who undergo treatment for H. pylori should receive confirmation of eradication with fecal antigen test, urea breath test, or upper endoscopy and biopsy. Testing should occur at least 4 weeks after H. pylori treatment completion and at least 2 weeks after stopping acid suppression medications.
¶ Refer to UpToDate content for details of treatment regimens, including medication doses and dosing frequency.
Δ Few clinical data exist to guide regimen selection in these patients, but H. pylori resistance to rifabutin and amoxicillin is low.
◊ Patients should be re-treated with BQT only if the initial BQT regimen included either (a) substitution of doxycycline for tetracycline or (b) metronidazole dose <1.5 g/day.
§ For details on H. pylori antimicrobial susceptibility testing, refer to UpToDate content on the diagnosis and treatment of H. pylori infection.