First-Line Therapy for H. pylori

👉 Bismuth quadruple therapy (BQT) = preferred empiric regimen, esp. where clarithromycin resistance is high.

✅ PPI + Tetracycline + Metronidazole + Bismuth

🔹 PCAB (vonoprazan)–based regimens = effective alternatives.

🚫 Avoid levofloxacin first line.
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