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H. pylori eradication in penicillin allergy — GPhC CRA MCQ

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ModerateGI TherapeuticsH. pylori eradication in penicillin allergyGPhC CRA

A 46-year-old man presents asking about Helicobacter pylori eradication. His GP has diagnosed H. pylori following a positive urea breath test. He has a documented penicillin allergy (anaphylaxis). What is the most appropriate eradication regimen?

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Correct answer: E — Omeprazole, metronidazole, and clarithromycin for seven days

For patients with a penicillin allergy, the standard triple therapy using amoxicillin is contraindicated. NICE CKS recommends a PPI with metronidazole and clarithromycin for seven days as an alternative regimen. This avoids amoxicillin-containing regimens. The two-drug regimen of PPI and clarithromycin alone is insufficient, and bismuth-based quadruple therapy, while effective, is not first-line in UK guidelines.

Reference: NICE CKS H. pylori; BNF