Treatment (10 to 14 days of therapy recommended)CostConvenience factorTolerability
Triple therapy
1. Omeprazole (Prilosec), 20 mg two times daily$260 (LAC)Twice-daily dosingFewer significant side effects, but more abnormal taste versus other regimens
or
Lansoprazole (Prevacid), 30 mg two times daily195 (LAC)
plus
Metronidazole (Flagyl), 500 mg two times daily200 (OAC)
or
Amoxicillin, 1 g two times daily194 (LMC)
plus
Clarithromycin (Biaxin), 500 mg two times daily199 (OMC)
2. Ranitidine bismuth citrate (Tritec), 400 mg twice daily118 (RCT)Twice-daily dosingIncreased diarrhea versus other regimens
plus
Clarithromycin, 500 mg twice daily
or
Metronidazole, 500 mg twice daily136 (RCA)
plus
Tetracycline, 500 mg twice daily73 (RMT)
or
Amoxicillin, 1 g twice daily92 (RMA)
Quadruple therapy
3. Bismuth subsalicylate (Pepto Bismol), 525 mg four times daily/2 tablets four times daily142 (BMT§ plus H2R)18 pills dailyMore side effects; increased nausea versus other regimens
plus
Metronidazole, 250 mg four times daily87 (BMT [separately] plus H2R)
plus
Tetracycline, 500 mg four times daily
plus
H2RA for 28 days
4. Bismuth subsalicylate, 525 mg four times daily/2 tablets four times daily206 (BMT plus PPI)18 pills dailyIncreased nausea
plus
Metronidazole, 250 mg four times daily
plus
Tetracycline, 500 mg four times daily153 (BMT separately] plus PPI)
plus
PPI for 14 days