H. pylori Tx Regimens, Pediatric >35 kg

clarithromycin and metronidazole susceptible

[14 day regimen]

[amoxicillin 1 g PO bid OR metronidazole 500 mg PO bid] + [clarithromycin 500 mg PO bid] + [PPI PO bid (see options below)]

[10 day regimen]

[amoxicillin 1 g PO bid] + [PPI PO bid (see options below)] x5 days, then [clarithromycin 500 mg PO bid] + [metronidazole 500 mg PO bid] + [PPI PO bid (see options below)] x5 days

clarithromycin susceptible, metronidazole resistant

[14 day regimen]

[amoxicillin 1 g PO bid] + [clarithromycin 500 mg PO bid] + [PPI PO bid (see options below)] +/- [bismuth subsalicylate 262 mg PO qid (<10 yo) or 524 mg PO qid (10 yo or older)]

clarithromycin resistant, metronidazole susceptible

[14 day regimen]

[amoxicillin 1 g PO bid] + [metronidazole 500 mg PO bid] + [PPI PO bid (see options below)] +/- [bismuth subsalicylate 262 mg PO qid (<10 yo) or 524 mg PO qid (10 yo or older)]

clarithromycin and metronidazole resistant or susceptibility unknown

[14 day regimen]

[amoxicillin 1.5 g PO bid] + [metronidazole 500 mg PO bid] + [PPI PO bid (see options below)] +/- [bismuth subsalicylate 262 mg PO qid (<10 yo) or 524 mg PO qid (10 yo or older)]

[14 day regimen]

[amoxicillin 1 g PO bid] + [metronidazole 500 mg PO bid] + [clarithromycin 500 mg PO bid] + [PPI PO bid (see options below)]

PPI options

[standard doses bid]

esomeprazole 40 mg PO bid; lansoprazole 60 mg PO bid; omeprazole 40 mg PO bid; pantoprazole 80 mg PO bid; rabeprazole 40 mg PO bid