Prevention

Triple therapy: ^b

• a proton-pump inhibitor plus amoxicillin and clarithromycin ^{a b}
• a bismuth compound plus a nitroimidazole and clarithromycin ^a or tetracycline ^b

• Triple therapy is more effective than dual therapy ^b
• Eradication rates are highest using a proton-pump triple therapy (87%: 95% CI: 86% to 87%) ^b , followed by a bismuth compound plus nitroimidazole plus tetracycline (82%: 95% CI: 80% to 84%) ^b
• Adding ranitidine bismuth citrate to a nitroimidazole and clarithromycin is more effective at eradiction than adding a proton-pump inhibitor. ^a There is no clear difference between the two when using amoxicillin and clarithromycin. ^a