Penicillin allergy

Usual Pathogen

Helicobacter pylori

Bismuth quadruple therapy

Empiric Therapy Dose Duration
PPI bid 14 days
+    
Bismuth subsalicylate 2 tabs (524mg) PO qid  
+    
Metronidazole 500mg PO qid  
+    
Tetracycline 500mg PO qid  

Alternative

Empiric Therapy Dose Duration
Pantoprazole 40mg PO bid 14 days
+    
Clarithromycin 500mg PO bid  
+    
Metronidazole 500mg PO bid