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H. pylori peptic ulcers are treated with drugs to kill the bacteria, drugs to reduce stomach acid, and drugs to protect the lining of the stomach. The antibiotics most commonly used to kill the bacteria are: amoxicillin, clarithromycin, metronidazole, and tetracycline. Drugs used to reduce stomach acid may be histamine blockers or proton pump inhibitors. The most commonly used histamine blockers are: cimetidine, famotidine, nizatidine, and ranitidine. The most commonly used proton pump inhibitors are: lansoprazole and omeprazole. The drug bismuth subsalicylate (a component of Pepto-Bismol) is used to protect the stomach lining.
The most common drug treatment is a two-week course of treatment called triple therapy. This treatment regimen involves taking two antibiotics to kill the bacteria and either an acid reducer or a stomach-lining shield. This therapy has been shown to kill the bacteria, reduce ulcer symptoms, and prevent ulcer recurrence in over 90% of patients.
The main drawback of triple therapy is that some patients find it difficult to follow because it often requires taking as many as 20 pills a day. The antibiotics may also cause unpleasant side effects that may make certain patients less likely to follow the treatment protocol. These side effects include: dark stools, diarrhea, dizziness, headache, a metallic taste in the mouth, nausea, vomiting, and yeast infections in women.
— Paul A. Johnson
