GI drugs: H. pylori regimens: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · GI drugs: H. pylori regimens

Sample item

Where clarithromycin resistance is high or the first regimen has failed, which regimen is preferred for Helicobacter pylori?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Bismuth-based quadruple therapy with a PPI, bismuth, tetracycline and metronidazole

Bismuth quadruple therapy avoids clarithromycin and is recommended in areas of high resistance and for treatment failure. Standard triple therapy contains a PPI, clarithromycin and amoxicillin.

Option by option

  • A. PPI with amoxicillin alone

    Dual therapy with amoxicillin alone is inadequate.

  • B. PPI with clarithromycin and amoxicillin repeated

    Repeating clarithromycin when resistance is likely fails.

  • C. Omeprazole alone

    A PPI alone does not eradicate H. pylori.

  • D. Bismuth-based quadruple therapy with a PPI, bismuth, tetracycline and metronidazole (correct)

    Correct. Bismuth quadruple therapy is preferred in this context.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Bismuth-based quadruple therapy with a PPI, bismuth, tetracycline and metronidazole. Bismuth quadruple therapy avoids clarithromycin and is recommended in areas of high resistance and for treatment failure.

Why is "PPI with amoxicillin alone" not the answer?

Dual therapy with amoxicillin alone is inadequate.

Why is "PPI with clarithromycin and amoxicillin repeated" not the answer?

Repeating clarithromycin when resistance is likely fails.

Why is "Omeprazole alone" not the answer?

A PPI alone does not eradicate H. pylori.

What concept does this question test?

It tests GI drugs: H. pylori regimens in Pharmacology. Standard triple therapy contains a PPI, clarithromycin and amoxicillin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study GI drugs: H. pylori regimens?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.