Regimen 1 and regimen 2 are equally effective.
b Omeprazole can be replaced with other PPIs given every 12 h.
c Meta-analyses show that 2 weeks’ treatment gives a slightly improved
eradication rate worldwide, but side effects are increased. In northern
Europe, the success rate using 1 week of triple therapy is still high enough
to be recommended in most guidelines. However, some recent audits
suggest that success rates may be falling, so this guidance may change.
d Culture and antibiotic sensitivity testing may be used as an alternative
to ‘blind’ treatment with second-line drugs. Other second- and third-line
treatments are available (incorporating levofloxacin or rifabutin in the
treatment regimens), but should be reserved for use by specialist units.