Helicobacter pylori (H. pylori) is a bacterium colonising the gastric mucosa and may be the causative agent in a number of gastrointestinal pathologies.
Initial testing for H. pylori may be done by laboratory-based serology, urea breath test and stool antigen test. Re-testing should always be done using urea breath test.
One week therapy with a proton pump inhibitor (PPI) and two antibiotics is recommended:
Omeprazole oral 20mg twice daily (or lansoprazole oral 30mg twice daily)
Clarithromycin oral 500mg twice daily
Amoxicillin oral 1g twice daily.
If penicillin allergy, then prescribe PPI as above as well as:
Clarithromycin oral 250mg twice daily
Metronidazole oral 400mg twice daily.
N.B. Healing of gastric ulcers must be confirmed by endoscopy after 6 – 8 weeks.
Content last reviewed May 2019