Helicobacter
Please note: This is for information only.
Refer to local guidelines for treatment recommendations.
- Gram-negative spiral rods, difficult to isolate from clinical samples as slow growing.
- Breaks down urea using the enzyme urease.
- Culture is now rarely required, mainly done on biopsies to test for antibiotic sensitivity and follow up as diagnosis is usually confirmed by the urea breath test or serological evidence of infection.
Main clinical infections:
- Chronic peptic ulcer, dyspepsia (refractory to conventional treatment), gastric MALT.
Usually sensitive to:
1st Line Triple therapy (for 1 week):
PPI (usually omeprazole 20mg) bd
plus
Metronidazole 400mg bd
plus
Clarithromycin 250mg bd
- Following eradication of H. pylori associated with duodenal ulcers uncomplicated by haemorrhage or perforation, the British Society of Gastroenterology (BSG) recommends that continued proton pump inhibitor (PPI) is not required.
- For H. pylori associated with gastric ulcers, the BSG recommend continuing with 2 months of PPI following eradication, or until healing is confirmed at endoscopy.
Usually resistant to: