Tag: Bismuth quadruple therapy

According to the American College of Gastroenterology (ACG), eradication of *H. pylori* can no longer be assumed due to increasing antibiotic resistance, with successful treatment relying heavily on patient adherence and an appropriate regimen. This makes understanding the correct dosage and answering "How long should I take medicine for *H. pylori*?" crucial for successful eradication.

According to the American College of Gastroenterology (ACG)'s 2024 guidelines, bismuth-based quadruple therapy is the strongly recommended first-line treatment for treatment-naive *H. pylori* patients. The question of which antibiotic is best for treating *H. pylori* is complex, as the optimal choice depends on several factors, including regional antibiotic resistance rates, prior antibiotic exposure, and patient-specific considerations like allergies. The rising prevalence of antibiotic resistance has led to a significant shift away from older, less effective triple-therapy regimens.

The World Health Organization (WHO) has classified clarithromycin-resistant *H. pylori* as a high-priority pathogen, highlighting the urgent need for effective eradication strategies. This shift in bacterial resistance means there is no single "strongest" antibiotic for *H. pylori*; instead, the most effective treatment depends on regional resistance patterns, patient history, and the use of multi-drug regimens.

Clinical guidelines have recommended bismuth-containing quadruple therapy, which includes the active ingredient in Pepto-Bismol, as a first-line treatment for *H. pylori* infections, especially in regions with high antibiotic resistance. So, what does Pepto-Bismol do to H. pylori and why is it so effective when combined with other medications?