Treatment of gastric ulcers and gastritis with antibiotics: a regimen, a list of drugs

Gastric ulcer, however, like gastritis, is considered a rather insidious pathology, because the causes that cause it are so diverse, how dangerous the consequences of the disease, if left untreated. Probably the most common cause of ulcers in one or more parts of the gastrointestinal tract is a bacterial infection, and the pathogens are known only to small children. Protect the gastric mucosa from a bacterial attack will help only antimicrobial drugs. Those. Antibiotics for a stomach ulcer are not a whim of a doctor, but a harsh necessity.

When are antibiotics prescribed for gastric ulcer?

Gastric ulcer is a pathology similar in many respects to a popular gastritis, in which the inflammatory process, small lesions (erosive gastritis) and hemorrhages (hemorrhagic gastritis) can be observed on the mucous organ. Only in case of ulcerative lesions of the stomach on its mucous membrane are found deeper wounds. Such damage can be either single or multiple.

The cause of gastric ulcer development can be as a dysfunction of secretory organs, in connection with which the acidity of the gastric juice appreciably increases and causes irritation of the mucosa of the main digestive organ, as well as some subjective causes (malnutrition, prolonged intake of hormonal and anti-inflammatory drugs, stress, frequent use of alcoholic beverages , smoking).

The doctor puts the diagnosis of "stomach ulcer" when the patient has the following symptoms: acute pains in the stomach (hungry, nocturnal, after eating), which quickly pass after taking antacids and analgesics, uncaused feeling of hunger, nausea, vomiting (sometimes bloody), belching with a sour or metallic aftertaste, a feeling of heaviness in the epigastrium, and stool disorders. The presence of such symptoms allows the doctor to suspect a stomach ulcer, but to confirm the diagnosis and identify the cause of the pathology can only be after a special endoscopic examination of the stomach - fibrogastroduodenoscopy (FGDS).

Most often the ulcer develops against a background of chronic gastritis with increased secretory function of the stomach. It is not characterized by an acute current. This is a chronic pathology with periods of exacerbation and remission.

Since the stomach ulcer most often develops against the background of increased acidity of gastric juice, which is the optimal variant of the habitat and reproduction of the bacterium Helicobacter pylori, it is this bacterium that is found in most patients.

To determine by eye whether pathology has a bacterial cause is simply impossible. So you need to do some research before you prescribe treatment, and especially antibiotics for a stomach ulcer. Confirm or deny the presence of Helicobacter Pylori in the body will help FGDS, during which the doctor not only examines the internal surface of the stomach, but also measures the pH of the gastric juice and makes an analysis of the bacterial pathogen. To detect the presence of Helicobacter Pylori helps and test in the exhaled air.

Indications for the use of antibiotics in gastric ulcer is the corresponding diagnosis and the presence of bacterial infection in the body, confirmed by appropriate analyzes. If the ulcer of the stomach does not have a bacterial nature, there is no point in prescribing antibiotics.

Such a disease as a stomach ulcer in its pure form is rare, usually inflammatory-ulcerative process has the property to spread deep into the body, capturing the initial parts of the intestine (duodenum). Therefore, the diagnosis most often sounds like this - a stomach ulcer and 12 duodenal ulcer. Antibiotics for gastric ulcer and duodenal ulcer are prescribed for the same indications as for gastric ulcer that has not spread to other organs.

The same antibiotics and treatment regimens with their use are prescribed for gastritis, because with their help it is necessary to fight with the pathogen, which is found even in the stomach ulcer. Helicobacter pylori can equally become both a cause of gastritis and a factor that causes ulcerative processes in the digestive tract. It is she who makes the stomach and intestinal mucosa more sensitive to the effects of various stimuli, for example, gastric juice.

Name and description of popular antibiotics for gastric ulcer

The traditional approach to the therapy of bacterial gastric ulcer involves the use of popular broad-spectrum antimicrobials that are used to treat not only gastrointestinal diseases, but also bacterial pathologies of the respiratory and genitourinary system, skin infections, inflammatory diseases of the brain, etc.

In gastroenterology it is customary to treat gastric ulcer with antibiotics of the following groups:

• semisynthetic penicillins (mainly "Amoxicillin"),
• macrolides (preference is given to "Clarithromycin", although in some treatment schemes there is also "Erythromycin").

There are also popular regimens for treating gastric ulcers and gastritis, where one of the antimicrobials is a broad-spectrum antibiotic and the antiprotozoal effect of Metronidazole.

Less often, treatment regimens are used, in which Tetracycline is one of the antibiotics. They are practiced in the case when another treatment has not produced a result, as well as with the patient's intolerance to penicillins.

Let us consider in more detail what the above antibiotics are for the ulcer of the stomach, what are their contraindications and side effects.

Amoxicillin

Semisynthetic antibacterial preparation of penicillin series with the same active ingredient. Has a wide range of antibacterial activity. Among microorganisms that are sensitive to the effects of the drug, it is found popular in gastroenterology Helicobacter pylori.

Form of issue. The pharmaceutical industry produces the drug in the form of tablets or capsules (250 and 500 mg), as well as granules, which are used to prepare the suspension. To treat stomach ulcers, the antibiotic is given in tablet form.

Pharmacodynamics. The drug is famous for its pronounced bactericidal action, i.e. It does not inhibit the process of multiplication of microorganisms, but destroys the cellular structure of the bacterium, which leads to its death.

Pharmacokinetics. Antibiotic is characterized by rapid absorption during oral administration, which is important for infectious diseases of the gastrointestinal tract, because in this way both local and systemic therapy of pathologies is performed, in which microorganisms are localized in the gastrointestinal tract. The maximum concentration of active substance in the blood and in the liver can be determined after 1-2 hours after taking the drug.

The intake of food does not affect the absorption of the drug, and the acidic environment of the stomach is not capable of destroying the active substance. The half-life of the antibiotic is approximately 1-1 ½ hours. It is excreted mainly with urine and feces.

Use during pregnancy. The active substance of the drug is able to penetrate the placenta to the fetus, so the use of antibiotic in pregnancy is limited. It is prescribed if bacterial pathology is a danger to the life of a woman. The use of the drug during pregnancy had no pronounced negative effect of amoxicillin on the fetus.

During lactation, an antibiotic is not advisable, since it has the ability to penetrate various body environments, including breast milk. For the period of treatment with the drug the baby is transferred to artificial feeding.

Contraindications. The drug is not used if the stomach ulcer and other infectious diseases of the digestive system are accompanied by frequent vomiting and diarrhea. In this case, you first need to remove the described symptoms, and then begin treatment.

Doctors do not prescribe this antibiotic for infectious mononucleosis, lymphocytic leukemia, respiratory diseases of viral etiology, hay fever, bronchial asthma. You can not use a penicillin antibiotic with hypersensitivity to beta-lactam AMP (penicillins and cephalosporins) and allergic diathesis.

In some schemes, "Amoxicillin" is prescribed in conjunction with "Metronidazole". This scheme of treatment is unacceptable for diseases of the nervous system, hematopoietic disorders, as well as negative reaction of the body to the reception of nitroimidazole derivatives.

Side effects. Reception of an antibiotic can be accompanied by such undesirable symptoms as an allergy to a drug in the form of skin rashes, a cold, conjunctivitis, angioedema, joint pain. With penicillin intolerance, anaphylactic shock can rarely develop.

With reduced immunity, the development of superinfections is possible. Long-term use of large doses of the drug may cause ataxia, dizziness, fainting, seizures and other symptoms.

Simultaneous reception of "Amoxicillin" and "Metronidazole" in some patients can cause nausea, vomiting, stool, stomach pain, stomatitis.

Overdose. Taking a large dose of an antibiotic is usually accompanied by a disorder of the stomach and a violation of the water-electrolyte balance. In kidney disease, there may be symptoms of nephrotoxicity, sometimes salt crystals are found in urine.

First aid: washing the stomach and taking activated charcoal. In a hospital, hemodialysis can be performed.

Interaction with other drugs. Parallel reception of amoxicillin and bactericidal preparations enhances the therapeutic effect. It is not used concomitantly with bacteriostatic antibiotics.

An increase in the concentration of amoxicillin in the blood can cause diuretic and non-steroidal anti-inflammatory drugs, allopurinol, probenecid, phenylbutazone.

Glucosamines, antacids, aminoglycosides, laxative drugs can adversely affect the absorption of the drug in the digestive tract. But ascorbic acid only promotes effective absorption of amoxicillin.

Metronidazole enhances the activity of amoxicillin against Helicobacter pylori.

Storage conditions. The drug is stored at room temperature, protecting from sun and moisture. Keep away from children.

Shelf life. The drug retains bactericidal properties for 3 years.

[1], [2], [3], [4], [5], [6]

Clarithromycin

Semisynthetic antibiotic of a wide spectrum of antimicrobial activity from the group of macrolides, considered to be the safest AMP due to the small number of side effects.

Form of issue. The drug can be found on pharmacy shelves in the form of tablets of 250 or 500 mg.

Pharmacodynamics. The action of the drug against Helicobacter pylori is bactericidal, as it inhibits the biosynthesis of the protein, which is the main building material of the bacterial cell membrane.

Pharmacokinetics. Clarithromycin is a drug with non-linear pharmacokinetics that stabilizes within 2 days. Accept it regardless of eating, which can have a slight effect on the rate of absorption. Partially destroyed in the acidic environment of the stomach, so it is better to use for the treatment of ulcers that develop against the background of normal acidity.

The antibiotic creates sufficient concentrations in the gastric mucosa, which is facilitated by the simultaneous administration of the drug with "omeprazole."

Use during pregnancy. It is undesirable to use in the first trimester of pregnancy and during breastfeeding, since the effect of the drug on the fetus is insufficiently studied. In the 2nd and 3rd trimester appoint for vital indications.

Contraindications. The drug is not prescribed for patients with ventricular arrhythmias and QT interval prolongation according to anamnesis data, hypokalemia, severe liver and kidney disorders, hypersensitivity to antibiotics from the macrolide group and intolerance of some components of the drug.

Side effects. Usually the drug is tolerated well by patients and does not cause negative symptoms. In less than 10% of patients, epigastric pain, nausea, dyspepsia, changes in taste, insomnia can occur.

Overdose. The use of large doses of the drug causes unpleasant symptoms from the gastrointestinal tract. Recommended gastric lavage and symptomatic therapy.

Interaction with other drugs. It is inadmissible to use clarithromycin concomitantly with lovastatin and simvastatin.

Warfarin on the background of clarithromycin therapy can provoke severe bleeding.

The use of the drug with antidiabetic drugs often causes pronounced hypoglycemia, with aminoglycosides - toxic reactions.

Clarithromycin is not allowed in parallel with cisapride, pimozide, astemizole, terfenadine, ergot preparations.

Storage conditions. It is recommended to store the antibiotic at a temperature of up to 30 ^о С, protecting from exposure to sunlight and moisture. Keep away from children.

Shelf life. The drug retains its properties for 2 years, after which it can no longer be taken.

[7], [8], [9], [10], [11]

Metronidazole

Antibiotic of a wide spectrum of antimicrobial activity with antiprotozoal properties. Its active substance is an imidazole derivative.

Form of issue. The drug comes in the form of 250 mg tablets.

Pharmacodynamics. Has a destructive effect on the DNA of the molecular cell of the bacterium.

Pharmacokinetics. As with previous drugs, it has a rapid absorption in the digestive tract. Easily penetrates into various environments of the body, where it reaches therapeutic concentrations. It is excreted in urine and feces.

Use during pregnancy. According to animal studies, metronidazole is not able to cause malformations of the fetus, although it penetrates the placenta, but because of the lack of such studies on the human body, the drug is prescribed during pregnancy only if there is evidence of a risk to the life of a woman.

Breastfeeding for the duration of therapy with the drug should be discontinued.

Contraindications. The drug is not prescribed for hypersensitivity to its components. In pediatrics apply from 6 years of age.

Side effects. The drug may be accompanied by unpleasant symptoms of digestive disorders, reversible pancreatitis, hot flashes, skin rashes and itching, allergic and anaphylactic reactions. Sometimes patients complain of headache, convulsions, dizziness, confusion, visual impairment, hallucinations, which requires the abolition of the antibiotic. There may be small changes in blood tests.

Urine acquires a reddish-brown color, which is due to the peculiarities of the metabolism of the drug.

Overdose. Taking a large dose of the drug may cause vomiting and impaired orientation. Treatment is symptomatic.

Interaction with other drugs. Metronidazole is not allowed to be combined with disulfiram and busulfan, which can lead to dangerous consequences. Antibiotic is incompatible with alcohol and drugs containing alcohol.

Caution is necessary to take metronidazole and such drugs as rifampicin and fluorouracil. Simultaneous reception of antibiotic and lithium preparations can cause toxic effects.

Storage conditions. Store the antibiotic at room temperature in a dark, dry room. Keep away from children.

Shelf life. The drug retains its properties for 2 years.

Tetracycline

A broad-spectrum antibiotic with a bacteriostatic effect that inhibits the multiplication of bacteria, in connection with which their number gradually decreases.

Pharmacokinetics. The half-life of the drug is 8 hours. It is excreted in urine and feces, and can be re-absorbed in the intestine.

Use during pregnancy. NOT used in therapy of pregnant and lactating women.

Contraindications. The drug is not prescribed for fungal infections, severe liver and kidney pathologies, lupus erythematosus, leukopenia, hypersensitivity to tetracyclines. In pediatrics is used since 8 years.

Side effects. The most common side effects: nausea, stomach pain, diarrhea, dizziness, allergic reactions of varying severity, increased photosensitivity, symptoms of deficiency of B vitamins, the development of secondary fungal infections associated with a violation of the microflora of the body.

Overdose. It manifests itself in the form of increased side effects, the appearance of extraneous elements in the urine. Treatment is symptomatic.

Interaction with other drugs. Simultaneous use with drugs of vitamin A can cause an increase in intracranial pressure.

It is not advisable to apply simultaneously with bactericidal antibiotics.

Metal-containing preparations, antacids, colestyramine, colestipol worsen the absorption of tetracycline.

Storage conditions. The drug is stored at room temperature, protecting from sun and moisture. Keep away from children.

Shelf life. It retains its properties for 3 years.

For the irradiation of Helicobacter pylori, all of the antibiotics described above are very rarely used as monotherapy. Usually, for this purpose, prescribe in accordance with one of the regimens for the treatment of gastric ulcers, which includes 3 or more drugs.

Innovative drugs for the treatment of stomach ulcers

So, the classical approach to the treatment of gastric ulcer caused by the bacterium Helicobacter pylori, involves a combination of 2 broad-spectrum antibiotics and additional drugs that protect the gastrointestinal mucosa and potentiating the action of antimicrobial agents. Thus, the patient must simultaneously take 2 to 4 tablets, buying several drugs at once.

The modern pharmacological industry has taken a step forward and developed drugs that combine the action of several drugs. Among the innovative antibacterial agents, one can find both combined preparations ("Pylobakt Neo" and "Helicocin"), as well as bismuth preparations (the popular "De-Nol").

The very name of the combined preparations speaks about their appointment. Indication for the use of these AMP is the need for irradiation (destruction) of Helicobacter pylori. Antibiotics are prescribed for stomach ulcers and duodenal ulcers, gastritis and duodenitis associated with a bacterial infection.

Pilot Neo

The composition of this drug is as close as possible to one of the treatment regimens for bacterial gastric ulcer: amoxicillin + clarithromycin + omeprazole. The drug is essentially a combined set of drugs needed to fight Helicobacter pylori. It is used as a monotherapy.

Form of issue. In the package of the drug you can find tablets of 2 antibiotics and capsules of omeprazole in the amount necessary for the course of treatment (7 days). The package contains 7 blisters. Each blister includes 2 tablets of amoxicillin and clarithromycin and 2 capsules of omeprazole.

Pharmacodynamics. Antibiotics have a complex bactericidal action against the causative agent, and the proton pump inhibitor omeprazole reduces the volume and acidity of gastric juice, contributes to the increase in the concentration of AMP in the gastrointestinal mucosa, which makes irradiation therapy more effective without increasing the dose of antibiotics.

Use during pregnancy. The drug is not allowed during pregnancy and lactation.

Contraindications. The drug is not prescribed for hypersensitivity to any of its components, infectious mononucleosis, pathological changes in blood, oncological pathologies. It is intended for therapy of patients older than 16 years.

Side effects. Combined drug is quite good tolerability. Unpleasant symptomatology, characteristic of each of the components of the complex, has a light current and is reversible. The inclusion of omeprazole in the drug may cause increased photosensitivity, minor hair loss, muscle weakness, pain in the muscles and joints.

Method of application and dosage. The course of treatment with the drug is designed for 7 days. The drug is taken 2 times a day: in the morning and in the evening in equal doses (1 tablet of amoxicillin and clarithromycin and 1 capsule of omeprazole). One blister is designed for 1 day of therapeutic course.

Tablets and capsules are not chewed, but swallowed with water.

Overdose. If you adhere to the recommended scheme and dosage of treatment, an overdose does not occur. Otherwise, symptoms of a gastrointestinal disturbance, headache and dizziness, confusion, allergic reactions may appear.

Storage conditions. The best conditions for storage of the combined preparation is considered dry and dark place at a temperature of 25 to ^about C

Shelf life. Use the drug without harm to health can be for 2 years.

An analogue of the above described drug is "Ornistat" (composition: proton pump inhibitorrabeprasol sodium, antibiotics: ornidazole and clarithromycin).

Helicocin

Combined drug based on amoxicillin and metronidazole. It is used in the complex therapy of gastric ulcers, gastritis and duodenitis caused by bacterial infection.

Form of issue. Packaging contains blisters with 2 types of tablets: oval - metronidazole 500 mg, and round - amoxicillin 750 mg.

Pharmacodynamics. Antibiotics in the drug mutually enhance the bactericidal action of each other, prevent the development of antibiotic resistance to the drug, prevent the relapse of stomach ulcers.

Pharmacokinetics. The drug is quickly absorbed into the digestive tract, its maximum concentration in the blood is observed after 1-2 hours after administration. It is excreted in urine and feces.

Use during pregnancy. The use of the drug is acceptable only for vital indicators after evaluating all risks.

Contraindications. The drug is not prescribed for individual intolerance to any of the components of the drug. Other contraindications can be seen by reading the appropriate section of the instructions for "Amoxicillin" and "Metronidazole".

Not applicable in pediatrics.

Side effects. If the doctor's appointments are observed, no undesirable effects are observed. Possible side effects: worsening of appetite, nausea and vomiting, diarrhea, metallic taste in the mouth, changes in the color of urine, headaches, allergy manifestations.

Method of administration and dose. In the absence of pathologies of the liver and kidneys, the drug is prescribed 2-3 times a day. A single dose includes one round and one oval tablet. If the liver or kidneys are not functioning properly, the antibiotic is taken no more than 2 times a day.

Overdose. Occurs when the recommended dose is exceeded. It manifests as nausea and vomiting, dizziness, migraine-like pain, drowsiness or insomnia, weakness.

Storage conditions. It is recommended to store the combined antibiotic in a non-flammable room (the temperature of the air should not be above 25 ^о С), away from sunlight and moisture. Keep away from children.

Shelf life. Use within 4 years from the date of manufacture indicated on the package.

De Nol

A noisy drug with good advertising, claiming that it is the best remedy for fighting Helicobacter pylori. In fact, the medicine is not referred to antibiotics, but to a group of antacids and absorbents.

Form of issue. The drug is available in the form of tablets with engraving and a slight smell of ammonia. They are sealed in blisters of 8 pieces. There are 7 or 14 blisters in the medicine package.

Pharmacodynamics. Antimicrobial properties of the drug are due to its active substance - bismuth subcitrate. Doctors have long noted the positive properties of bismuth-containing drugs in the therapy of inflammatory gastrointestinal diseases, because these drugs, in addition to protecting the mucosa, also have a bactericidal action against the popular Helicobacter pylori.

In addition to bactericidal, the drug is also attributed to a more pronounced antiulcer (enveloping, astringent) and gastroprotective action. On the surface of the mucous membrane of the stomach, it forms a special film, which does not allow the acid in the gastric juice to act on inflamed tissues and ulcers, which in this way get the opportunity to quickly scar.

Gastroprotective action of bismuth is associated with stimulation of the production of prostaglandin E2 in the body, which improves microcirculation in the tissues of the stomach and DPC, which reduces the level of hydrochloric acid and the activity of pepsin, which are irritating factors for the sensitive mucosa of the stomach weakened by bacterial infection.

Pharmacokinetics. The active substance is practically not absorbed into the digestive tract. The blood gets only a small part of it. Nevertheless, even the local antibacterial action, according to the instructions, has a very good effect, since no other strain of Helicobacter pylori has developed resistance to bismuth subcitrate.

With long-term administration of the drug, bismuth subcitrate is able to accumulate in the blood plasma and its antibacterial effect is enhanced. The medicine is excreted mainly with feces.

Use during pregnancy. Medicines based on bismuth compounds are not intended for therapy of women during pregnancy and breastfeeding.

Contraindications. Such comparatively few. The drug can not be prescribed for hypersensitivity to any component of the drug, as well as in severe renal failure.

In pediatrics, the drug is used to treat small patients aged 4 years.

Side effects. Negative symptoms during the administration of the drug are mainly limited to reactions from the gastrointestinal tract. This is nausea, sometimes accompanied by vomiting, stool disorders (constipation or diarrhea). Such symptomatology is temporary and does not pose a danger, as well as rare allergic manifestations (mainly lungs in the form of skin rash and itching).

The accumulation of bismuth in the blood with prolonged therapy in large doses is fraught with lesions of the nervous system with the development of encephalopathies, since it is supplied with blood to the central nervous system, where it partially settles.

Method of administration and dose. The daily dose for therapy of patients over 12 years is 480 mg (4 tablets). They can be taken one at a time 4 times a day or divided the daily dose equally into 2 divided doses.

The infant dose is in the range of 1-2 tablets. Calculation of the effective daily dosage is carried out according to the formula: 8 mg of the drug per kilogram of body weight of the patient.

Take the medicine before meals, washed down with clean water or weak tea. You can eat half an hour after taking the drug.

Overdose. The use of large doses of bismuth subcitrate is fraught with the development of renal failure and disruption of the CNS.

Treatment consists in washing the stomach, taking activated charcoal and saline laxatives. Effective blood purification with hemodialysis.

Interaction with other drugs. The drug is able to reduce the absorption of tetracyclines. Antacids, fruits and dairy products reduce the effectiveness of the drug. Therefore, they can be consumed with an interval of half an hour before or after taking the tablets.

Storage conditions. Like many other drugs for irradikatsii Helicobacter Pylori, «De-Nol" should be stored in a dry, dark room with an air temperature within 15-25 ^on pp away from children.

Shelf life. Use for 4 years. The release date and expiration date are indicated on the package and in the annotation to the medicine.

Advertising of the drug does not give complete information on the use of the drug, which makes it possible to assume that De-Nol is able to deal solely with the irradiation of Helicobacter pylori. Hence, many negative reviews, allegedly the drug is ineffective, and advertising is aimed at "pumping out" money.

In fact, the manufacturers themselves recommend De-Nol for the treatment of Helicobacter Pylori as part of complex therapy (specially developed multicomponent antibiotic regimens), where bismuth sub-citrate acts as an antacid, an antibacterial component and a substance that reduces the resistance to the main antibiotics, for example , to Metronidazol.

[12], [13], [14], [15], [16], [17]

Method and dosage of antibiotics for gastric ulcer

In gastroenterology for the treatment of pathologies caused by bacterial infection, including ulcers of the stomach associated with Helicobacter Pylori, it is customary to use three- and four-component antibiotic regimens. In these schemes, there are usually 1-2 antibiotics and additional components that regulate the acidity of the stomach.

Consider the most popular regimens for treating stomach ulcers.

2-component regimens with a course of treatment of 14 days

• "Omeprazole" + "Amoxicillin". Omeprazole is taken in a dosage of 20-40 mg, amoxicillin 750 mg. Multiplicity of admission - 2 times a day.
• "Omeprazole" + "Clarithromycin". Omeprazole is taken in a dosage of 40 mg in the morning, clarithromycin - 500 mg three times a day.
• "Omeprazole" + "Amoxicillin." Omeprazole is taken as in the previous scheme, amoxicillin - from 750 to 1500 mg twice a day.

Classical 3-component scheme treatment of gastric ulcers includes drugs such as antibiotic (clarithromycin, amoxicillin, metronidazole) antisecretory drugs (omeprazole, pantoprazole et al.) And histamine H ₂ receptor antagonists (ranitidine, pilorid et al.) . However, recently such schemes have slightly lost their popularity due to the emergence of new resistant strains of Helicobacter pylori. To solve the problem of antibiotic resistance, it was common to use 2 antibiotics in the regimens simultaneously.

3-component schemes with a course of treatment 10 days

• "Clarithromycin" + "Metronidazole" + "Ranitidine." The drugs are taken twice a day in a single dose of 250, 400 and 150 mg.
• "Tetracycline" + "Metronidazole" + "Pilorid." The drugs are prescribed in a dosage of 250, 400 and 400 mg, respectively. Multiplicity of admission - 2 times a day.
• "Amoxicillin" + "Metronidazole" + "Omeprazole." Omeprazole is taken at a dosage of 40 mg in the morning, amoxicillin at a dosage of 500 mg and metronidazole is 400 mg three times a day.

An example of a 3-component scheme with a weekly course of therapy:

• Amoxicillin + Clarithromycin + Nexium. The drugs are prescribed in a single dosage respectively 1000, 500 and 20 mg. Multiplicity of medication - 2 times a day.

4-component schemes with a course of treatment 7 days

• Metronidazole + Tetracycline + Omeprazole + De-Nol. Single doses of the drugs are respectively 250, 500, 20 and 120 mg. The first 2 drugs are taken 4 times a day, omeprazole - 2 times a day, "De-Nol" - every 4 hours (4-5 times a day).
• Metronidazole + Tetracycline + Novobismol + Ranitidine. Single dosage of drugs, respectively, 250, 200, 120 and 300 mg. Ranitidine is taken 2 times a day, the rest preparations - 5 times a day.

Example of a 4-component scheme with a 10-day course:

• "Metronidazole" + "Amoxicillin" + "Omeprazol" + "De-Nol". Single dosage of drugs, respectively, 250, 500, 20 and 120 mg. Omeprazole is taken 2 times a day, the rest preparations - 3 times a day.

As a rule, one of the components of the 4-component treatment regimens are bismuth preparations (subcitrate or bismuth subsalicylate). Selection of effective treatment regimens should be performed by a specialist specialist, based on the patient's condition, severity of the disease, individual and age characteristics of the patient's body.

Let's consider possible schemes or plans of reception of antibiotics at a stomach ulcer:

• "De-Nol" + "Metronidazole" + "Flemoxin." Bismuth subcitrate is taken at a dosage of 240 mg twice a day with a monthly course, antibiotics in a dosage of 400 and 500 mg 3 times a day, weekly course.
• "De-Nol" + "Metronidazole" + "Tetracycline." Bismuth subcitrate is taken in a dosage of 120 mg, antibiotics, respectively, at a dosage of 400 and 500 mg. Multiplicity of reception of the complex - 4 times a day. The course of treatment is 1 week.
• "De-Nol" + "Metronidazole" + "Clarithromycin". Bismuth subcitrate is taken in a dosage of 240 mg, antibiotics in a dosage of 400 and 250 mg. Multiplicity of reception of the complex - 2 times a day. The course of treatment is 10 days.
• "De-Nol" + "Flemoxin" + "Clarithromycin". Bismuth subcitrate is taken in a dosage of 240 mg, antibiotics, respectively, 1000 and 250 mg. Multiplicity of reception of the complex is 2 times a day, the course of treatment is 7 days.
• "De-Nol" + "Clarithromycin" + "Tetracycline." Dosage of drugs, respectively, 120, 250 and 250 mg. Multiplicity of reception of the complex - 4 times a day. The course of treatment is 10 days.
• "De-Nol" + "Flemoxin" + "Omeprazole." The dosage of the drugs is 120, 500 and 20 mg, respectively. Admission of omeprazole is carried out 2 times a day, antibacterial drugs - 4 times a day. The course of treatment is 14 days.
• "De-Nol" + "Clarithromycin" + "Omeprazole". Bismuth subcitrate in a dosage of 120 mg is taken 4 times a day, an antibiotic and omeprazole in a dosage of 500 and 40 mg, respectively, 2 times a day. The course of treatment is 7 days.

There are also effective schemes with "Furazolidone" (antimicrobial and antiprotozoal drug, a derivative of nitrofuran), which also helps to solve the problem of antibiotic resistance. The most popular is the scheme:

"De-Nol" + "Amoxicillin" + "Furazolidon." Single dose of drugs, respectively, 240, 500 and 100 mg. Bismuth subcitrate is taken 2 times a day, the rest preparations - 4 times a day. The course of treatment is 14 days.

In this scheme, "Ampicillin" is sometimes replaced with "Flemoxin Solutab" or a drug from the group of protected penicillins.

Other recommended schemes with "Furazolidone" and bismuth sub-citrate:

• "De-Nol" + "Furazolidon" + "Clarithromycin". Single dose of drugs, respectively, 240, 100 and 250 mg.
• "De-Nol" + "Furazolidon" + "Tetracycline." Single dose of drugs, respectively, 240, 200 and 750 mg.

In both schemes, all drugs are taken 2 times a day. The course of treatment is 7 days.

All of the above drugs help to fight with bacterial infection, which reduces the likelihood of recurrences of stomach ulcers. However, in order to stabilize the patient's condition, antibiotic therapy should be combined with the following:

• antacids,
• histamine receptor blockers,
• proton pump inhibitors,
• gastro-cytoprotectors,
• holinoblokatorov,
• ganglion blockers,
• antispasmodics,
• prokinetics,
• preparations of bismuth.

Only an integrated approach to treatment of the stomach will give a positive result, while antibiotics in the stomach ulcer will prevent relapses of the disease caused by the activity of Helicobacter pylori.