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- Title
The efficacy of bismuth containing quadruple therapy as a first-line treatment option for Helicobacter pylori.
- Authors
UYGUN, Ahmet; KADAYIFCI, Abdurrahman; SAFALI, Mukerrem; ILGAN, Seyfettin; BAGCI, Sait
- Abstract
BACKGROUND: Helicobacter pylori eradication rates have tended to decrease recently, mostly due to increasing antibiotic-resistance. The present study aimed to compare the efficacy of bismuth-based quadruple regimen with proton pump inhibitor-based triple regimen for eradication of H. pylori. METHODS: Consecutive H. pylori-positive patients with non-ulcer dyspepsia were randomized into one of two regimens: (i) bismuth subsalicylate 300 mg q.i.d., lansoprazole 30 mg b.i.d., tetracycline 500 mg q.i.d. and metronidazole 500 mg t.i.d. (BLTM group) for 14 days; (ii) lansoprazole 30 mg b.i.d., amoxicillin 1 g b.i.d and clarithromycin 500 mg b.i.d. (LAC) for 14 days. Gastroscopy and 14C-Urea breath test (UBT) were performed before enrollment, and UBT only was repeated for 6 weeks after treatment. RESULTS: A total of 240 patients were randomized into groups and 212 of them completed the protocols. The ‘intention-to-treat’ (ITT) and ‘per protocol’ (PP) H. pylori eradication rates were 70% (95%CI 61–78) and 82.3% (95%CI 74–89) in the BLTM group, and 57.5% (95%CI 48–66) and 62.7% (95%CI 53–71) in the LAC group. The BLTM treatment achieved a significantly better eradication rate compared with LAC treatment in PP analysis (82.3% vs. 62.7%, P = 0.002). Mild to severe side-effects, which were more frequent in the BLTM group, were reported in 18.2% of the patients. CONCLUSION: The bismuth-based quadruple regimen achieved a better eradication rate compared with proton pump inhibitor-based triple regimens as a first-line eradication option for H. pylori in our population.
- Subjects
THERAPEUTICS; BISMUTH; HELICOBACTER pylori; PROTON pump inhibitors; INDIGESTION; METRONIDAZOLE
- Publication
Journal of Digestive Diseases, 2007, Vol 8, Issue 4, p211
- ISSN
1751-2972
- Publication type
Article
- DOI
10.1111/j.1751-2980.2007.00308.x