Almost all treatment recommendation for gastritis, duodenitis or peptic ulcer that has Helicobacter pylori, calls for 2 or 3 antibiotic at the same time, why is that ?
Why not use a single effective antibiotic?
The aim of taking two antibiotics at the same is to prevent an overgrowth of the H. pylori strains that could be resistant to a single antibiotic. The antibiotic choice depends on the individual sensitivity to antibiotics.
Various treatment regimes have been proposed: Helicobacter pylori treatment: antibiotics or probiotics (Applied microbiology and biotechnology, 2018).
A standard treatment regime for the H. pylori infection of the stomach is a triple therapy for 10-14 days:
Probiotics taken along with triple therapy can increase the eradication rate.
In recent years, the effectiveness of the triple regime has fallen from 90% to <70% due to resistance of H. pylori to multiple antibiotics. The reported prevalence of resistance to:
Quadruple therapy (for areas with high incidence of clarithromycin resistance):
The efficacy of the quadruple therapy in H. pylori eradication is similar than in triple therapy (~77%).
Sequential therapy uses the same drugs as the triple therapy but not at the same time (more effective in patients with the single clarithromycin-resistant strain; eradication rates were 80.9% for sequential therapy and 40.7% for standard triple therapy):