Endoscopy Unit Documentation 2011 NHS Lothian Lothian Health Guidelines on Eradication of

The Helicobacter Pylori eradication regimes used in the Royal Infirmary of Edinburgh are those recommended by the multidisciplinary group from the Lothian University NHS Trust (Royal Infirmary and Western General Hospital) and St John's Hospital, West Lothian (2003).  Acid lowering drug therapy enhances the efficacy of H.pylori eradication therapy and can usually be discontinued after ONE WEEK unless there is a complicating factor such as gastric ulcer, perforated ulcer, bleeding ulcer, NSAID therapy or troublesome reflux symptoms  The combination of TWO antibiotics together with a Formulary PPI given for at least ONE WEEK is required to ensure H.pylori eradication rates >85%  ‘Blind' anti- H.pylori therapy without prior confirmation of H.pylori status is only appropriate in Helicobacter pylori eradication therapy
First line therapy:
Second line therapy:
First line if penicillin
Second line if penicillin
 Up to 30% of patients will experience diarrhoea with H.pylori eradication therapy. Patients should be warned of this adverse effect and advised to complete the therapy. Serious side effects are rare  Patients should avoid alcohol during metronidazole therapy because of the possibility of  Contraceptive drug therapy is less effective during antibiotic therapy and the use of an additional barrier contraceptive method is strongly advised  A paediatrician should supervise H.pylori eradication in children  Symptoms may persist beyond 1 week where there has been peptic ulceration. In this event, the PPI should be continued alone for up to four weeks (especially if gastric ulcer)  The absence of symptoms 4 weeks after eradication therapy is strong evidence that eradication has been successful. Confirmation of H.pylori eradication in patients who are asymptomatic at 4 weeks is unnecessary unless there has been bleeding or perforation of a peptic ulcer or where there are relevant ongoing risk factors e.g. anti-coagulant or NSAID therapy. When indicated, the H.pylori breath test is best deferred for 5 weeks after the conclusion of eradication therapy.  H.pylori eradication therapy interacts with warfarin and may cause disturbances in INR Please Note: The information contained within this document is under Copyright and has been prepared by the Endoscopy Unit for the sole purpose of
informing Clinical Staff of the protocols and Guidelines adopted within this unit and should not be freely distributed.
The Endoscopy Unit have made all reasonable efforts to ensure the accuracy of the information on this site, but can take no responsibility for your use of it. Nor can the Endoscopy Unit take responsibility for anything contained in other linked sites. The purpose of the site is informational and educational, and it is not a substitute for medical advice. If you are in any doubt as to your medical condition, or if you are in need of advice, you should consult your doctor or other


Purification of His6-tagged Proteins Metal Chelate Chromatography with Sartobind® Membrane Adsorbers Materials and Methods Production of Bgl-His E.coli BL21 (DE3) pET-bgl-His6-sec was Proteins cultivated in 300 ml medium (10 g/l peptone,Green fluorescent protein (GFP) and β-glu-10 g/l yeast extract, 20 g/l glycerol, 10 g/lcanase were used, which were fused with His6NaCl, 100 m

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