Clinicians who manage Helicobacter pylori infection must stay up to date on proper management of drug therapy, according to the American College of Gastroenterology (ACG). To that end, ACG recently provided recommendations to help clinicians choose the best antibiotic regimen and to avoid common treatment errors. Among its recommendations:

• Ask patients if they have received previous treatment for the infection and incorporate that information into the decision making process.
• Only prescribe clarithromycin triple therapy as first line therapy to patients who have not been exposed to macrolides and who live in areas where resistance to the antibiotic is low.
• Prescribe bismuth quadruple therapy or concomitant therapy consisting of a proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole to most patients as first line therapy.
• For patients who don’t respond to first line treatment with clarithromycin, the best approach is bismuth quadruple therapy or levofloxacin.