What are the antibiotics to eradicate Helicobacter pylori?

At present, there are six kinds of antibiotics recommended for the treatment of Helicobacter pylori infection in China: amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin and furazolidone. The drug resistance rates of amoxicillin, tetracycline and furazolidone are very low or almost non-resistant, while the drug resistance rates of clarithromycin, metronidazole and levofloxacin are very high or very high. Some foreign knowledge/guidelines also recommend rifabutin as a remedial treatment to eradicate Helicobacter pylori. Rifampicin is a second-line anti-tuberculosis drug. Because of the high incidence and drug resistance rate of tuberculosis in China, it is not recommended.

Helicobacter pylori is not easily resistant to amoxicillin (penicillin drugs), so it is the most commonly used drug to eradicate Helicobacter pylori at present. But people who are allergic to penicillin affect its application. Those who are allergic to penicillin can be replaced by cefuroxime, and the curative effect is basically the same. Clarithromycin belongs to macrolides, and it is still a drug with high curative effect (if not drug resistance) to eradicate Helicobacter pylori, and it is cross-resistant with other macrolides. Tinidazole can replace metronidazole and minocycline (a semi-synthetic tetracycline) can replace tetracycline. The adverse reactions of these substitutes may be slightly lower, but the drug resistance rate is the same as that of recommended drugs, which can not improve the curative effect. Levofloxacin belongs to fluoroquinolones and is used for remedial treatment. Using sitafloxacin instead of levofloxacin in Japan can improve the curative effect to some extent. China scholars use berberine instead of other antibiotics to eradicate Helicobacter pylori, and its efficacy needs to be confirmed by more studies.