CLA and MET susceptible | CLA resistant MET resistant | |||||
Previous treatment | Triple therapy OAC* | Triple therapy OAM† | Sequential therapy | Triple therapy OAC* | Triple therapy OAM† | Primary antimicrobial unknown susceptibility |
Rescue therapy | Triple therapy OAM† 14 days | Triple therapy OAC* 14 days | Consider endoscopy use treatment 14 days or treat like double resistence‡ | Consider endoscopy use treatment 14 days or treat like double resistence‡ | Treat like double resistence‡ | Consider endoscopy to antimicrobial susceptibility or treat like double resistence‡ |
Data from ESPGHAN/NASPGHAN guidelines.2
Sequential therapy, bismuth-based and concomitant therapy: see table 3.
*OAC: PPI-amoxicillin-clarithromycin.
†OAM: PPI-amoxicillin-metronidazole.
‡Double resistance: triple therapy with high-dose amoxicillin 14 days, bismuth-based, concomitant therapy 14 days.
CLA, clarithromycin; MET, metronidazole; PPI, proton pump inhibitor.