- Causes most cases of PUD
- Most prevalent human infection in the world
- Endoscopically: rapid urease test, histology, culture
- Serologic test (IgG Ab to H. Pylori, however stays + after eradication)
- Urea breath test (ingest labeled urea, H. Pylori bacterial urease break it down into labeled CO2 and ammonia, later detect the labeled CO2 in the breath)
- Stool antigen test (>90% sens and spec, also works as test of cure >4 weeks after completing treatment).
Treating H. Pylori will reduce recurrence of PUD
- Triple therapy: PPI, Clarithromycin, + amoxicillin OR metronidazole for 10-14 days
- Quadruple therapy (If resistance to Clarithromycin): PPI, bismuth, metronidazole, and tetracycline
Bjorkman, David J. “Quadruple Therapy for Helicobacter Pylori Infection.” Medscape, 28 Apr. 2011, www.medscape.com/viewarticle/740249.