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H. pylori Eradication — RACP Adult Medicine MCQ

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ModerateGastroenterology & HepatologyH. pylori EradicationRACP Adult Medicine

A 48-year-old man presents with a 2-month history of epigastric pain relieved by eating and recurring 2–3 hours postprandially. Helicobacter pylori breath test is positive. He has no alarm features. According to eTG, what is the recommended first-line H. pylori eradication regimen in Australia?

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Correct answer: E — Triple therapy: PPI + amoxycillin + clarithromycin for 14 days

Australian eTG recommends standard triple therapy (PPI BD + amoxycillin 1 g BD + clarithromycin 500 mg BD) for 14 days as first-line H. pylori eradication (extended from 7 days due to rising clarithromycin resistance rates and improved eradication with longer course). If penicillin-allergic, metronidazole replaces amoxycillin. Eradication should be confirmed with a urea breath test ≥4 weeks after completing treatment.

Reference: eTG – 2025 – Gastrointestinal