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?
Medical Sciences Stack Exchange is a question and answer site for professionals in medical and allied health fields, students of those professions, related academics, and others with a sound understanding of medicine and healthcare-related sciences. It only takes a minute to sign up.Sign up to join this community
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):