2nd line therapy

Helicobacter pylori

Use an alternate 1st line therapy, i.e.: 

• If Concomitant quadruple therapy was used as initial treatment, use Bismuth quadruple therapy for second treatment round.
• If Bismuth quadruple therapy was used as initial treatment, use Concomitant quadruple therapy, or consider PPI + amoxicillin + levofloxacin (see 3rd line therapy).

Concomitant quadruple therapy

or

Bismuth quadruple therapy