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2nd week: PPI (standard dose), amoxicillin 1 g, metronidazole 0.5 g and clarithromycin 0.5 g bid First line therapy Bismuth-containing quadruple therapy 10–14 PPI (standard dose) bid, tetracycline 0.5 g qid, metronidazole 0.25 g qid and bismuth standard dose qid First line or second line therapy Levofloxacin-based triple therapy 10
Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. [11] It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. [11] It is effective for dracunculiasis, giardiasis, trichomoniasis, and amebiasis. [11]
Metronidazole is an antibiotic with an off-label use in eradicating H. pylori for treating gastric ulceration. Resistance of metronidazole is above 15% worldwide. [ 32 ] It is likely to be resistant so is not the first line choice of treatment. [ 44 ]
Helicobacter pylori colonizes the stomach for decades in most people, and induces chronic gastritis, a long-lasting inflammation of the stomach. In most cases symptoms are never experienced but about 10–20% of those infected will ultimately develop gastric and duodenal ulcers, and have a possible 1–2% lifetime risk of gastric cancer.
Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. [1]
Rebamipide, an amino acid derivative of 2-(1H)-quinolinone, is used for mucosal protection, [1] healing of gastroduodenal ulcers, and treatment of gastritis. [2] It works by enhancing mucosal defense, scavenging free radicals , [ 3 ] and temporarily activating genes encoding cyclooxygenase-2 .
Metronidazole in combination with alcohol causes severe reactions such as vomiting and flushes in many patients. Tetracycline resorption is reduced by dairy products, antacids and other products containing calcium , magnesium , aluminium as well as iron .
The GI cocktail is a mixture of a viscous anesthetic, an antacid, and an anticholinergic. [1] [2] Common viscous anesthetics use are viscous lidocaine or xylocaine.Common antacids used are magnesium hydroxide, aluminum hydroxide, or simethicone (more commonly known as Mylanta or Maalox). [3]