Which regimen is used to treat Helicobacter pylori infection?

• A. Amoxicillin monotherapy
• B. Metronidazole alone
• C. Clarithromycin-based triple therapy
• D. Ciprofloxacin alone

Answer: (C)

Eradicating Helicobacter pylori relies on combination therapy that both suppresses stomach acid and attacks the bacteria with two antibiotics. The standard approach is a proton pump inhibitor plus two antibiotics, commonly clarithromycin-based triple therapy: a PPI to raise gastric pH and improve antibiotic activity, along with clarithromycin and amoxicillin (or metronidazole if penicillin allergy) for about 10–14 days. This combination targets the bacterium through different mechanisms and reduces the chance of resistance, leading to higher eradication rates.

Monotherapy with amoxicillin or metronidazole alone is ineffective because H. pylori resistance and the need for dual antibiotic action require a regimen that includes both an acid-suppressing agent and two antibiotics. Ciprofloxacin alone is not a standard treatment for H. pylori.