Second-Line Therapy for HP

[kushtrim_k]

Dear prof Marshall,

I was diagnosed with HP, and 2 years ago I had standard first-line theray (omeprazole 20 mg bid, amoxicillin 1 g bid, clarithromycin 500 mg bid - 10 days). Since in my country there is no urea breath test, I waited 1 year to do again blood test, and result was HP positive. One doctor prescribed me quadruple therapy, whereas another one - triple therapy (omeprzole 20 mg bid, amoxicillin 1 g bid and metronidazole 400 mg bid).
Today, I decided to go with this therapy:ompeprazole 20 mg bid, amoxicillin 1 g bid and metronidazole 400 mg bid, and I am planning to have this treatment for 2 weeks.
Please, tell me if this is appropriate 2nd line treatment for helicobacter pylori infection. In addition, I would be grateful to you if you tell me if the metronidazole is safe to use more than 10 days, because it is listed as a potential human carcinogen on IARC list.

Thanks in advance,

Best regards,
Kushtrim Kelmendi, Kosova

[barjammar]

This is not such a bad treatment - it has few side effects and the cure rate for you is probably about 60%. I would have used higher doses.