Patients infected with Helicobacter pylori are often confused by a bunch of medications. In response to the above questions, the following is a comprehensive and systematic answer by our pharmacists.
Quadruple**. 
Hello, why did the doctor prescribe so much medicine to me, how long does it take to take this, how do I take it?”
In the outpatient medicine window**, we often encounter patients infected with Helicobacter pylori who will have such questions, and in response to the above questions, our pharmacists will give a comprehensive and systematic answer.
Helicobacter pylori (HP) is mainly parasitic in the gastric mucosal tissue, infection with Helicobacter pylori can cause chronic gastritis and peptic ulcer and other diseases, at the same time, Helicobacter pylori and gastric cancer, gastric mucosa-related lymphoid tissue lymphoma and gastroesophageal reflux disease and other diseases are closely related, is listed as the first class of biological carcinogens by the World Health Organization, so it is very necessary to carry out the first class of Helicobacter pylori.
At present, the guidelines recommend that the drug of Helicobacter pylori is mainly a "quadruple" regimen of bismuth + proton pump inhibitor (PPI) + two antibiotics, and at the same time, the quadruple drug must take a sufficient course of treatment to be possible** Helicobacter pylori, generally a course of treatment is 14 days, which is the reason why doctors prescribe more drugs.
How to take the drugs in the quadruple is very critical, and only when taken correctly can we achieve better results.
1.Bismuth. Bismuth is a mucosal protector that inhibits Helicobacter pylori by inhibiting HP-producing proteases, urokinases, and phospholipases. Commonly used bismuth agents include potassium bismuth citrate, bismuth colloidal tartrate and compound bismuth aluminate, etc., and bismuth is generally taken 30min before meals. Taking bismuth at the same time may cause black stools, which is a normal phenomenon and should not be alarmed, and it will disappear after stopping the drug.
2.Proton pump inhibitors (PPIs).
Proton pump inhibitors are the most powerful class of drugs that inhibit gastric acid secretion. Common drugs of this class are omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. This class of drugs inhibits gastric acid secretion and increases gastric pH, thereby providing a favorable sterilization environment for the two antibiotics to be applied later, so as to achieve a better bactericidal effect. Proton pump inhibitors should also be taken 30 minutes before meals.
3.Two antibiotics.
In the quadruple of Helicobacter pylori, two antibiotics need to be used for combined sterilization, and the commonly used antibiotics are amoxicillin, metronidazole, clarithromycin, furazolidone, levofloxacin, etc., of which any two can be selected.
In the actual selection and application, it should be noted that patients who are allergic to penicillin should not choose amoxicillin, patients under the age of 18 years old should not choose levofloxacin, and clarithromycin should not be taken at the same time as statin hypolipidemic drugs. Antibiotics should be taken 30 minutes after a meal.
Therefore, the correct order of taking medicine is to take bismuth and proton pump inhibitors 30min before meals, and then you can eat first, and then take two antibiotics 30min after meals for sterilization. In the process of taking the drug, avoid intermittent medication, and you must take the drug for 14 days to achieve the effect of Helicobacter pylori.
After 4 weeks of discontinuation, a repeat H. pylori test is done to determine whether it is positive without taking bismuth, antacids, and antibiotics.
At the same time, it is necessary to pay attention to the fact that Helicobacter pylori can be infected, and you need to divide the meals after returning home, and separate the dishes and chopsticks from the family to avoid cross-infection.
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