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Discussion 1Initial Prescription for the PatientThe given case study indicates that Mike 46-year-old patient is positive for Helicobacter pylori and this indicates that he is suffering from peptic ulcer disease (PUD). PUD is a chronic inflammatory condition of the stomach and duodenum(Woo & Robinson, 2015). It occurs due to increased acid and pepsin secretion, use of NSAIDs, H.pylori, impaired mucosal cytoprotection and personal factors such as stress, smoking, genetic or a combination of these factors (Woo & Robinson, 2015).A critical aspect in the treatment of PUD is the eradication of H.pylori and therefore, all recommended treatment regimens are based on a combination of proton pump inhibitor(PPI) and antimicrobial therapy (Woo & Robinson, 2015). Antimicrobial agents used in the treatment of PUD include amoxicillin, levofloxacin, clarithromycin, tetracycline, and metronidazole (Woo & Robinson, 2015). They are given in the form of a triple regimen or a quadruple drug regimen. The treatment regimen includes bismuth subsalicylate. Antimicrobial agents in combination with PPI helps in alleviating symptoms of an ulcer and heals mucosal inflammation. The first choice of triple therapy is a combination of proton pump inhibitor bid; Clarithromycin 500 mg bid and amoxicillin 1 g bid (Woo & Robinson, 2015).