Table 2

Regimens that have been used in the past but are generally not recommended as empiric treatment and treatments used as rescue treatment after failure of drug combinations in table 1

RegimenDescription (dosing, frequency, duration)
‘Legacy triple therapy’* 14 daysAmoxicillin 1000 mg twice a day
Clarithromycin 500 mg twice a day
PPI (standard dose) twice a day
Amoxicillin 1000 mg twice a day
Metronidazole 500 mg twice a day
PPI (standard dose) twice a day
Rescue triple treatments 14 daysAmoxicillin 1000 mg twice a dayon days 1–5
Third drug (eg, fluoroquinolone or rifabutin)
PPI (standard dose) twice a day for all 10 days
Bismuth quadruple rescue treatment 14 daysBismuth subcitrate or subsalicylate two tablets with meals and HS
Tetracycline HCl 500 mg with meals and HS
New drug (ie, furazolidone 100 mg three times a day)
PPI (standard dose) twice a day
High dose PPI amoxicillin dual treatment 14 daysPPI (full dose) every 6 h
Amoxicillin 500 mg every 6 h
  • * See text for details. In most regions of the world success with the clarithromycin-containing triple regimen has fallen to <80% and is should be avoided as an empiric treatment. Tailored treatment for patients with susceptible strains can be used.

  • Fluoroquinolone resistance is rapidly rising and it should not be used without prior susceptibility testing if a quinolone has been used previously for any indication or success with this type of treatment is known to be less than excellent locally.

  • HS, at bedtime; PPI, proton pump inhibitor.