Continuing Medical Education Questions: February 2017
© The American College of Gastroenterology 2017. All Rights Reserved.
- A 55-year-old man is admitted with an upper gastrointestinal bleeding secondary to a gastric ulcer, which was successfully treated with epinephrine injection and hemostatic clips. Gastric biopsies confirm Helicobacter pylori. He is treated with a 14-day course of amoxicillin, clarithromycin, and proton pump inhibitor (PPI). Fecal antigen testing 4 weeks later performed after discontinuation of PPI is positive for H. pylori. Which one of the following treatment regimens would you recommend next?
- Retreatment with amoxicillin, clarithromycin, and PPI with adjuvant probiotics for 14 days
- Dual therapy with high-dose amoxicillin and PPI for 7 days
- Quadruple therapy with bismuth, metronidazole, tetracycline, and PPI for 14 days
- Sequential therapy with amoxicillin and PPI for 5 days followed by clarithromycin, nitroimidazole, and PPI for 5 days
- Which one of the following antibiotics has the highest resistance rate?
- Which one of the following factors is the single most important predictor of success of treatment for H. pylori?
- Antibiotic sensitivity
- Low side effect profile of medications
- Cigarette smoking
- Loss of CYP2C19 function