Premium
The efficacy of bismuth containing quadruple therapy as a first‐line treatment option for Helicobacter pylori
Author(s) -
UYGUN Ahmet,
KADAYIFCI Abdurrahman,
SAFALI Mukerrem,
ILGAN Seyfettin,
BAGCI Sait
Publication year - 2007
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2007.00308.x
Subject(s) - lansoprazole , medicine , regimen , helicobacter pylori , gastroenterology , amoxicillin , metronidazole , breath test , clarithromycin , intention to treat analysis , proton pump inhibitor , rabeprazole , urea breath test , group b , randomized controlled trial , antibiotics , helicobacter pylori infection , microbiology and biotechnology , biology
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 14 C‐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.