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Pharmacology Anti Microbial d26ed846

Anti Helicobacter pylori drugs include all of the following except:

A
Amoxicillin
B
Clarithromycin
C
Metronidazole
D
Sucralfate
High-Yield Explanation
Ans: D (Sucralfate) Ref: The Pharmacological basis of therapeutics by Good man & Gilman - 12th edition, page no. 1320Explanation:Common eradication regimens Helicobacter pylori include triple therapy and quadruple therapy both of which are given for 14 days.Triple therapy - proton pump inhibitor + clarithromycin 500 mg + metronidazole 500 mg or amoxicillin 1 g BD or tetracycline 500mg QIDQuadruple therapy - Proton pump inhibitor twice a day + metronidazole 500 mg three times daily plus bismuth subsalicylate 525 mg + tetracycline 500 mg four times dailyQuadruple therapy is especially used in areas with high degree of resistane to H.pylori.Alternative regimen - H2 receptor antagonist BD plus bismuth subsalicylate 525 mg + metronidazole 250 mg + tetracycline 500 mg QIDAddition of proton pump inhibitor or H2 antagonist enhances the activity of effectiveness of the antibiotics used against H.pyloriMucosa associated lymphoid tissue lymphoma of the stomach also requires anti - H.pylori eradication regimen.SucralfateIt is not used in any of the H.pylori eradication regimens.It has a special role in the prevention of stress induced ulcers.When given in the rectal route they may be effective in radiation proctitis and solitary rectal ulcers.Since the drug contains aluminium, it should be avoided in patients with renal failure.

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