The first line of treatment according to the American College of Gastroenterology is clarithromycin triple therapy consisting of a PPI (Pantoprazole, Nexium, Aciphex), clarithromycin, and amoxicillin or metronidazole for 14 days (2020).
PPI would be prescribed 8-12 weeks, clarithromycin, and amoxicillin or metronidazole would be prescribed for 14 days. Patient would be instructed to follow-up 4 weeks after completion of treatment to ensure that the infection has been eradicated.
Some side effects from these medications include diarrhea, nausea, vomiting. To assist with these side effects, Ondansetron 4mg orally disintegrating tablet would be prescribed to help with nausea and vomiting for the diarrhea symptoms Bismuth subcitrate 120mg would be prescribed (Woo, & Robinson, 2020).
For patients diagnosed with GERD only, a PPI would be prescribed and education on lifestyle changes to improve symptoms. Lifestyle changes that can help alleviate GERD symptoms include elevating head of bed when lying down, avoiding spicy foods and acidic foods, avoid laying down after eating for at least 3 hours, limit caffeine intake, and other changes such as smoking cessation and weight loss.
American College of Gastroenterology (2020). Treatment of Helicobacter pylori Infection 112: 212-238; doi:10.1038/ajg.2016.563
Woo, T., M., & Robinson, M., V., (2020) Pharmacotherapeutics for Advanced Practice Nurse Prescribers. PA: F. A. Davis Company
What Would You Prescribe Initially?
The prescribed medication for Helicobacter pylori infection would be Aciphex for two weeks. However, the nurse taking care of the patient may double it with clarithromycin 50mg along with 1mg of Amoxicillin for a period of two weeks. This kind of treatment is known as triple therapy treatment (Dai & Jiang, 2018). In addition, the nurse practitioner would make sure the patients treatment is completed by prescribing a proton pump inhibitor taken for a period of three months.
How Long Would You Prescribe These Medications?
For treatment of Helicobacter pylori infection through triple treatment, it should not exceed two weeks. However, the exact period of medication therapy depends on the condition of the patient, and progress of the person in the industry (Pizza et al., 2020). However, other medications should be included to manage the side effects of the mediation of triple therapy medication.
What are the Possible Drugs You Could Prescribe To Manage The Side Effects From The Medications Prescribed?
To manage the side effects based on triple therapy treatment, the healthcare provider is required to prescribe additional medications (Mahboubi, 2019). For example, the side effects of clarithromycin and metronidazole could be controlled through the use of a proton pump inhibitor.
How Would The Treatment Vary If The Patient Has GERD Instead?
It is evident that the mode of treatment for the patient may vary if the health condition in question was GERD. For example, the nurse would encourage the patient to make an adjustment to lifestyle behavior. In addition, the head of the bed would need elevation, avoiding habits of laying down three hours after meal, and avoiding spicy and acidic foods and reducing the intake of caffeine (Oshima & Miwa, 2018). Other recommendations by the nurse practitioner may include maintenance of healthy weight, and avoiding smoking cigarette. In addition, a prescription of histamine 2 receptor antagonist and antacids may be prescribed along with the adjustment to lifestyle behavior. No sign of esophageal erosive condition was evident in the patient study case.