For Helicobacter pylori–associated duodenal ulcer, which regimen is commonly recommended?

• A. Metronidazole, tetracycline, and PPI
• B. Clarithromycin, amoxicillin, and PPI
• C. Levofloxacin, amoxicillin, and PPI
• D. Amoxicillin alone

Answer: (B)

Treating H. pylori–associated duodenal ulcers relies on regimens that combine acid suppression with two antibiotics to both boost healing and eradicate the bacteria. The most commonly recommended approach is a proton pump inhibitor paired with clarithromycin and amoxicillin. The PPI lowers stomach acid, which helps antibiotics work better and promotes ulcer healing. Amoxicillin provides reliable antibacterial activity with relatively low resistance, and adding clarithromycin improves the chance of eradicating the organism. This triple therapy is typically given for about 7 to 14 days. In areas with high clarithromycin resistance, this regimen is less effective, and alternative regimens such as bismuth quadruple therapy or other non‑clarithromycin combinations may be preferred. Amoxicillin alone cannot eradicate H. pylori.