As compared to tailored therapy, the use of empirical bismuth quadruple therapy (BQT) for 10 days was found to be safe, effective and cost effective option as per the clarithromycin resistance (CR) test for the eradication of Helicobacter pylori infection, a study in Digestive Diseases and Sciences concluded.

To distinguish between the efficacy of standard triple treatment (STT) and empirical BQT and; determine the cost-effectiveness of tailored treatment according to CR test outcomes, Young Woon Chang et al, considered 490 patients with H. pylori infection having chronic gastritis or stomach ulcer.

Out of these patients, 292 undertook CR testing. The patients on STT for a week and BQT for 10 days based on their CR test results were assigned to the tailored group (282 patients). The rest of the patients were in the empirical group (198 patients) who were subjected to BQT for 10 days.

About 32.2% patients (94 patients out of 292 patients) had a CR-positive rate in the tailored group. The eradication rates as per intention-to-treat analysis and per-protocol analysis has been represented in the following table:

Patients in the empirical group had lower frequency of adverse events as compared to tailored group (35.1% versus 52.7%, P < 0.001). Also, lower total per capita medical costs was beared by empirical group patients ($406.50 versus $503.50).