The patient is being treated for an H.pylori infection with proton pump inhibitor,metronidazole,and tetracycline but is not responding.The nurse expects that

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Triple-agent therapy with a proton pump inhibitor and two antibiotics for 14 days is the recommended treatment for eradication of H.pylori.In case first-line therapy fails,a bismuth-based quadruple therapy has been proven to be effective in 76% of patients.This second-line therapy consists of a PPI,bismuth,metronidazole,and a tetracycline.A 10-day course of levofloxacin may also be administered as a second-line therapy for H.pylori infections.

The Patient Is Being Treated for an H