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American College of Gastroenterology Clinical Guideline
There is increased resistance to clarithromycin, and traditional triple therapy (clarithromycin + amoxicillin + proton pump inhibitors [PPIs]) should not be prescribed unless the rates of clarithromycin resistance are known to be < 15%.
We should not use clarithromycin triple therapy.
Then what to use as First-Line Therapy
Quadruple therapy: Clarithromycin (500 mg),
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