A 55-year old with vague abdominal pain

A 55-year old with vague abdominal pain, symptoms of heartburn and nausea for 8 weeks underwent an upper endoscopy and biopsy of the gastric antrum. The electron microscopy of the organisms grown in culture is shown in the image. Since the patient is from an area where clarithromycin resistance is greater than 20%, what FDA approved regimen will you use to treat this patient?

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A. Amoxicillin Omeprazole and clarithromycin for 10 days
B. Metronidazole, bismuth, and tetracycline for 5 days
C. Lansoprazole, bismuth, tetracycline, and amoxicillin for 14 days
D. Amoxicillin, Bismuth, and tetracycline for 10 days