PPI (standard dose b.i.d.) Clarithromycin (500 mg b.i.d.) Amoxicillin (1000 mg b.i.d.) or metronidazole (400 mg b.i.d.) 7–14 In populations with less than 15–20% clarithromycin resistance.

Therefore, to reduce anaerobic malodour in vulnerable settings, we propose a ladder for metronidazole titration. High-risk patients should start with 400 mg thrice daily ×7 days and continue 200 mg ...