Continuing Medical Education Questions: February 2017Moawad, Fouad J MD, FACG1American Journal of Gastroenterology: February 2017 - Volume 112 - Issue 2 - p 239 doi: 10.1038/ajg.2016.607 CLINICAL GUIDELINES Free Author InformationAuthors Article OutlineOutline Article MetricsMetrics 1Scripps Green Hospital, La Jolla, CA If you wish to receive credit for this activity, please refer to the Web site:http://acgjournalcme.gi.org/. Article Title: ACG Clinical Guideline: Treatment ofHelicobacter pyloriInfection Questions: Back to Top | Article Outline Questions: 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? Metronidazole Clarithromycin Amoxicillin Tetracycline 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 © The American College of Gastroenterology 2017. All Rights Reserved.