Need ONE Response Per Each Discussion Total 3 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion

Robert Alonso

Florida National University

March 18, 2020

New therapy guidelines for H. Pylori treatment and patient education

1.

· Pepto Bismol [a bismuth subsalicylate] 525mg qid

· Metronidazole 250mg qid

· Adoxa [a tetracycline] 500mg qid

· Omeprazole [a proton pump inhibitor] qid

NB: the above medication is given for 7-14days.

2.

· In quadruple therapy the prolonged therapy treatment of beyond seven days is recommended as it enhances efficacy.

· The quinolones like levofloxacin should be used as substitutes for clarithromycin especially in proton pump inhibitor therapy.

· As long as quadruple therapy is concern, the therapy based on bismuth sub-citrate, tetracycline, omeprazole and metronidazole is best relative to triple therapy. Bismuth based quadruple therapy can be used as both primary and second line therapy in clarithromycin resistance cases.

· Sequential treatment therapy as new quadruple therapy is made up of a proton pump inhibitor, clarithromycin and nitoimidazole given for 5 days after proton pump inhibitor plus amoxicillin is already given for 5 days thus whole treatment duration is 10 days. In terms of eradication rate, this treatment is more efficient than the common triple therapy.

· In our common standard proton pump inhibitor triple therapy which had a duration of 7 days, the duration has been extended to 14 days so as to get rid of reduction in eradication rate.

· Visually, rifampicin, amoxicillin and tetracycline are not affected by resistance as compared to clarithromycin.

· Standard triple therapy of proton pump inhibitor plus clarithromycin and metronidazole or amoxicillin are considered first-line option worldwide.

· The best option of treating antimicrobial resistance in this therapy is using proven antibiotic regimen that has correct dosage and correct duration of treatment.

PATIENT EDUCATION

· Patients should be counseled on how to stop risk factors that lead to or increase dyspepsia and peptic ulcers like smoking, taking alcohol and stress-full behaviors.

· Patient with stomach ulcers should avoid NSAIDS drugs and tobacco at all cost for it enhances this condition.

· Patient should take drugs consistently and completely as indicated by the doctor’s prescription.

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References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071674/

https://academic.oup.com/pcm/article/2/2/77/5520678