Compared to Bismuth-containing therapy, a 14-day Polaprezinc-containing therapy may be more beneficial in maintaining short-term gut microbiota homeostasis following H. pylori treatment.

A randomized controlled trial examined whether Polaprezinc-quadruple therapy (PQT) causes negative microbiota effects in asymptomatic people in comparison with Bismuth-quadruple therapy (BQT).

Notably, 100 asymptomatic people infected with H. pylori were randomized (1:1) into the PQT group and the BQT group. Subjects had their faeces sampled both before and 4 to 8 weeks post-treatment. The 16S rRNA gene's V4 regions were sequenced from samples.

More than 95% of each intervention group was made up of the relative abundance of the 3 dominant bacterial phyla (Proteobacteria, Firmicutes, and Bacteroidota). There was no discernible variation in the alpha diversity between successful and unsuccessful H. pylori elimination. The BQT group's alpha diversity dropped compared to the baseline following a successful elimination.

Contrasted to volunteers in the PQT group, the BQT volunteers who efficiently eliminated H. pylori displayed significantly reduced alpha diversity indices at follow-up. When PQT was used to successfully remove Parasutterella genus, the prevalence was four times higher than when BQT was used.

PQT might offer promising benefits in maintaining gut microbiota homeostasis. These findings preliminarily offered evidence of the short-term effect of the gut microbiota following PQT treatment of H. pylori.