From a recent study, it was found that in patients with Helicobacter pylori (H. pylori) infection, a 10- day concomitant nonbismuth quadruple therapy may be preferred as first-line therapy. Compared to the 14-day regime, the 10-day regimen is better tolerated and is highly efficacious.

A prospective, open-label comparative study was conducted to investigate the efficacy and tolerability of 10-day versus 14-day concomitant nonbismuth quadruple therapy for H. pylori eradication in an area of high clarithromycin and low dual clarithromycin/metronidazole resistance.

In Greece, 264 adult patients infected with H. pylori without previous treatment were recruited in the study from September 2014 to June 2017. In the first phase of the study, concomitant therapy consisting of pantoprazole 40 mg, amoxicillin 1g, clarithromycin 500 mg, and a nitroimidazole 500 mg was administered twice daily for 10 days and in the second phase of the study, the therapy was given for 14 days. Utilizing chi-square and Fisher’s exact tests, the efficacy and side effects were compared.

In the per-protocol analysis and the intention to treat analysis, the rates of eradication for the 10- and 14-day regimen is depicted in the following table:

The rates of eradication were lower than 90% in the intention to treat analysis. In the 14-day group, the side effects were present in 31.3% of treated patients and were considerably more common. Treatment was discontinued by four patients, all in the 14-day group.

Thus, a 10-day concomitant nonbismuth quadruple therapy 10-day may be preferred as first-line treatment for managing H. pylori-infected patients. As per study authors, lower tablet burden and lower cost will additionally favor it as the first-line regimen of choice in clinical practice.