Page by: E.J. Mayeaux, Jr., M.D.
Louisiana State University Medical Center Shreveport, Louisiana
Pharmacy Eradication Generic Therapy Rate (%) Cost ---------------------------------------------------------------------- Triple-agent therapy for 14 days (1) >90 $3.00 to 7.50 Metronidazole, 250 mg orally four times daily with meals and in the evening plus Tetracycline, 500 mg orally four times 4.50 to 6.00 daily with meals and in the evening plus Bismuth (Pepto-Bismol), two tablets 9.00 orally four times daily before meals and in the evening Substitute amoxicillin, 500 mg orally four 70 16.00 to 22.00 times daily, in patients unable to take tetracycline, metronidazole or bismuth Second-line therapy for 14 days 50-80 16.00 to 22.00 Amoxicillin, 500 mg orally four times daily (2) plus Omeprazole (Prilosec), 20 mg orally 102.00 twice daily or Clarithromycin (Biaxin), 500 mg orally 85 125.00 three times daily plus Omeprazole, 20 mg orally twice daily 102.00
(1) Therapy should also include an H2-receptor antagonist for six to eight weeks to heal the ulcer ($90 to $170).
(2) The activity of amoxicillin is enhanced when it is taken with omeprazole. Omeprazole and amoxicillin should be started at the same time. An H2-receptor antagonist or omeprazole should be continued for four to six more weeks to heal the ulcer.
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