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Author: Admin | 2025-04-28
In divided doses for 4 to 8 weeks with or without ciprofloxacin (ACG [Lichtenstein 2018]).Dientamoeba fragilis infection (off-label use): Oral: 500 to 750 mg 3 times daily for 10 days (CDC 2012; Nagata 2012).Giardiasis (alternative agent) (off-label use): Oral: 250 mg 3 times daily or 500 mg 2 times daily for 5 to 7 days (Bartelt 2018; Drugs for Parasitic Infections 2013; Ordonez-Mena 2017).Helicobacter pylori eradication (off-label use):Clarithromycin triple regimen: Oral: Metronidazole 500 mg 3 times daily in combination with clarithromycin 500 mg twice daily and a standard-dose or double-dose proton pump inhibitor (PPI) twice daily; continue regimen for 14 days. Note: Avoid use of clarithromycin triple therapy in patients with risk factors for macrolide resistance (eg, prior macrolide exposure, local clarithromycin resistance rates ≥15%) (ACG [Chey 2017]; Fallone 2016).Bismuth quadruple regimen: Oral: Metronidazole 250 mg 4 times daily or 500 mg 3 or 4 times daily in combination with either bismuth subsalicylate 300 to 524 mg or bismuth subcitrate 120 to 300 mg 4 times daily, tetracycline 500 mg 4 times daily, and a standard-dose PPI twice daily; continue regimen for 10 to 14 days (ACG [Chey 2017]; Fallone 2016).Concomitant regimen: Oral: Metronidazole 500 mg twice daily in combination with clarithromycin 500 mg twice daily, amoxicillin 1 g twice daily, and a standard-dose PPI twice daily; continue regimen for 10 to 14 days (ACG [Chey 2017]; Fallone 2016).Sequential regimen (alternative regimen): Oral: Amoxicillin 1 g twice daily plus a standard-dose PPI twice daily for 5 to 7 days; then follow with clarithromycin 500 mg twice daily, metronidazole 500 mg twice daily, and a standard-dose PPI twice daily for 5 to 7 days (ACG [Chey 2017]); some experts prefer the 10-day sequential regimen (amoxicillin for 5 days, followed by metronidazole and clarithromycin for 5 days) over the 14-day sequential regimen (amoxicillin for 7 days, followed by metronidazole and clarithromycin for 7 days) due to the lack of data showing superiority of the 14-day regimen over the 10-day regimen in North America (ACG [Chey 2017]; Crowe 2018).Hybrid regimen (alternative regimen): Oral: Amoxicillin 1 g twice daily plus a standard-dose PPI twice
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