Need a response to the following:  Therapy guidelines for H. Pylori Treatment H. Pylori remains to be one of the most common chronic bacterial infection affecting humans. Research shows that H. Pylori is normally acquired during childhood, with most victims being those who are socially disadvantaged and people who have migrated to North America (Chey et al., 2017). Although currently, there are no new drugs that have been developed, treatment primarily depends on a mixture of antibiotics and anti-secretory agents. H. Pylori treatment regimens are such as triple therapy, sequential therapy, quadruple treatment, and levofloxacin-based triple therapy (De Francesco et al., 2017). In selecting the best treatment regimen, it’s important to consider previous antibiotic exposure, the rate of eradication, and regional antibiotic-resistance patterns as these can affect the successful treatment of the condition (Myran & Zarbock, 2018). Additionally, it can be noted that for a treatment to be effective and successful, then host factors such as allergies and patient adherence need to be considered (Fashner & Gitu, 2015).            Recent treatment guidelines have recommended quadruple therapy, which consists of PPI and three antibiotics (metronidazole, clarithromycin, and amoxicillin), which are to be administered concurrently (Chey et al., 2017). According to Shiotani et al. (2017), the rationale for this treatment option is that it’s not evidence-based but “hope-based” because gastroenterologists do believe that the infection would be susceptible to metronidazole or clarithromycin.             Patient compliance is a key factor that would determine treatment success. To minimize cases of side effects, clinicians should talk to their patients to adhere to their treatment plans and also instruct their patients on the right time to take their doses in relation to their meal (Li et al., 2019). Patients should be informed that they should avoid taking alcohol with metronidazole, avoid cheese, soy beans, and soy sauce taken with furazolidone (Li et al., 2019). Finally, it’s important to advice the patient to maintain personal hygiene by taking clean water and avoid ingesting contaminated food. The original work is below in case you needed: GI Case Study: Chief complaint: “I have recurrent H. Pylori infection”.  HPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.  PMH:  H. Pylori infection gastritis Diabetes Mellitus, type 2 Surgeries: None Allergies : NKDA .

1. Need a response to the following:
Therapy guidelines for H. Pylori Treatment
H. Pylori remains to be one of the most common chronic
bacterial infection affecting humans. Research shows that H.
Pylori is normally acquired during childhood, with most victims
being those who are socially disadvantaged and people who
have migrated to North America (Chey et al., 2017). Although
currently, there are no new drugs that have been developed,
treatment primarily depends on a mixture of antibiotics and
anti-secretory agents. H. Pylori treatment regimens are such as
triple therapy, sequential therapy, quadruple treatment, and
levofloxacin-based triple therapy (De Francesco et al., 2017). In
selecting the best treatment regimen, it’s important to consider
previous antibiotic exposure, the rate of eradication, and
regional antibiotic-resistance patterns as these can affect the
successful treatment of the condition (Myran & Zarbock, 2018).
Additionally, it can be noted that for a treatment to be effective
and successful, then host factors such as allergies and patient
adherence need to be considered (Fashner & Gitu, 2015).
Recent treatment guidelines have recommended
quadruple therapy, which consists of PPI and three antibiotics
(metronidazole, clarithromycin, and amoxicillin), which are to
be administered concurrently (Chey et al., 2017). According to
Shiotani et al. (2017), the rationale for this treatment option is
that it’s not evidence-based but “hope-based” because
gastroenterologists do believe that the infection would be
susceptible to metronidazole or clarithromycin.
Patient compliance is a key factor that would determine
treatment success. To minimize cases of side effects, clinicians

2. should talk to their patients to adhere to their treatment plans
and also instruct their patients on the right time to take their
doses in relation to their meal (Li et al., 2019). Patients should
be informed that they should avoid taking alcohol with
metronidazole, avoid cheese, soy beans, and soy sauce taken
with furazolidone (Li et al., 2019). Finally, it’s important to
advice the patient to maintain personal hygiene by taking clean
water and avoid ingesting contaminated food.
The original work is below in case you needed:
GI Case Study:
Chief complaint:
“I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old Hispanic female presents to the GI clinic for
complaint of recurrent H. Pylori infection. She was treated
about 2 ½ months ago with H. Pylori triple therapy and failed
treatment. She has PMH of dyspepsia, and GERD. She also
indicates that she has noticed that her symptoms of dyspepsia
are worsening for past 2 months. She has associated her
symptoms with nausea, upset stomach with all foods. Denies
associated symptoms of hematochezia, melena, hemoptysis,
abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries:

3. None
Allergies
:
NKDA
Vaccination History:
Up-to-date
Social history:
High school graduate, married and no children. He frequently
eats out in restaurants. He drinks one 4-ounce glass of red wine
daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea
Pedis. Mother alive and has history of atopic dermatitis, tinea
corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea.
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No
constipation. No melena. No abdominal pain.
Physical examination:

4. Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP
110/70 T 98.0 po P 80 R 22, non-labored
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4
quadrants. No organomegaly. Normal contour; No palpable
masses.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine
normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98
normal
Assessment:
Primary Diagnosis:
Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:
two months ago and
failed.
Clarithromycin 500 mg po BID for 2 weeks
Omeprazole 40 mg po BID for 2 weeks and then po daily.

5. Cipro 500 mg po BID for 2 weeks
Plan: Tests
Pt had EGD done 2 weeks ago that showed H. Pylori positive
gastritis in biopsy results.
Urea breath test 8 weeks after treatment with H. Pylori
medications. Pt needs to stop PPI’s 2 weeks prior to Urea
Breath test.
Labs:
No new labs are needed.
Referrals
: may refer based on effect of medication therapy given for 2
weeks.
Follow up:
return to office in 8 weeks to reevaluate symptoms.
As a future nurse practitioner, it is important that you determine
the medications used for recurrent H. Pylori infection.
Please discuss new therapy guidelines for H. Pylori treatment,
and provide patient education.