Answer Happy

Question 26 Currently favoured regimens for eradication of Helicobacter pylori are triple therapy with a proton pump inhibitor along with two antibiotics for 1 week. For example: • Omeprazole 20 mg + metronidazole 400 mg and clarithromycin 500 mg (all twice daily). • Omeprazole 20 mg + clarithromycin 500 mg and amoxicillin 1g (all twice daily). Resistance to amoxicillin has not yet been demonstrated. Previously, regimens such as omeprazole, metronidazole, amoxicillin and clarithromycin were recommended; are these regimens no longer used? The reason behind this question is the 'sky-high' cost of clarithromycin in Pakistan, which is inversely proportional to patient compliance (that is, low-cost regimens tend to have a higher rate of compliance).