A recent study illustrated that in patients infected with H. pylori, allicin-containing quadruple therapy may be regarded as a promising alternative to bismuth-containing quadruple therapy to eradicate H. pylori.

A study aimed to investigate and compare the safety, efficacy, and tolerability of allicin-containing quadruple therapy and bismuth-containing quadruple therapy in 220 H. pylori-infected patients. It also explored the factors that affect the eradication rates.

Participants were randomly allocated to 14-day quadruple therapy: ilaprazole (5 mg twice a day [bid]), doxycycline (100 mg bid), and furazolidone (100 mg bid) with an allicin soft capsule (40 mg of diallyl trisulfide [DATS] thrice a day [tid]) (IDFA group) or colloidal bismuth tartrate (220 mg of elemental bismuth bid) (IDFB group). Using urea breath tests, the eradication was confirmed. Adverse events, symptom improvement, and adherence were evaluated by a questionnaire.

Results

In the intention-to-treat and per-protocol analysis, the eradication rates for IDFA and IDFB groups as first-line and second-line therapies are shown in the following table:

Compared to the IDFA group, the symptom improvement rates, adverse event rates, and the occurrence of nausea were greater in the IDFB group as depicted in the following table:

The efficacy was considerably affected by smoking and sharing utensils. Thus, allicin-containing quadruple therapy may be a favorable alternative to bismuth-containing quadruple therapy in H. pylori-infected patients.