According to a randomized controlled trial, Minocycline-containing bismuth quadruple therapy (BQT) as a first-line regimen for Helicobacter pylori (H. pylori) management had comparable eradication effectiveness to that of classic Tetracycline-containing BQT, with comparatively good compliance and safety. Researchers compared first-line BQT using Tetracycline and Minocycline in order to examine the compliance, safety, and eradication rate.

Overall, 434 naïve subjects with H. pylori infection were enrolled. The volunteers were randomized to a 14-day Tetracycline-consisting BQT group (Metronidazole 400 mg four times a day [q.i.d.]/Esomeprazole 20 mg two times a day [b.i.d.]/bismuth potassium citrate 110 mg q.i.d. and Tetracycline 500 mg q.i.d.) and Minocycline-consisting BQT group (bismuth potassium citrate 110 mg q.i.d., Esomeprazole 20 mg b.i.d., Metronidazole 400 mg q.i.d., and Minocycline 100 mg b.i.d.).

Following elimination, safety and compliance were evaluated within three days. To assess the effectiveness, urea breath testing was done 4-8 weeks post-elimination. To contrast the rates of elimination, a noninferiority test was employed. For categorical variables, the intergroup differences were assessed using the Pearson chi-squared or Fisher's exact test. The Student's t-test was utilized for continuous variables.

According to the findings of both intention-to-treat (ITT) and per-protocol (PP) analyses, the lower limit of the 95% confidence interval difference rate for Minocycline- and Tetracycline-containing BQT was >-10.0%, as shown in Table 1:

The occurrence of adverse events (75/215 [34.9%] vs. 88/214 [41.1%]) and compliance (195/215 [90.7%] vs. 192/214 [89.7%]) were comparable across the two groups, with the exception of dizziness being more prevalent (35/215 [16.3%] vs. 13/214 [6.1%]) in Minocycline-containing BQT group. When used as the first-line regimen for the eradication of H. pylori, the BQT containing Minocycline and BQT containing Tetracycline were similar with regard to compliance, efficacy and safety.