Comparative analysis of antibiotic therapies for H. pylori elimination

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Created On: 16/08/2023

The objective of a randomized controlled trial was to examine the effectiveness of triple, quadruple, and sequential antibiotic therapies for Helicobacter pylori (H. pylori) elimination.

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Key take away

In people with H. pylori infection, 14-day standard triple therapy, 14-day bismuth-based quadruple therapy, and 10-day sequential therapy exhibit comparable efficacy in eradicating H. pylori

Background

The objective of a randomized controlled trial was to examine the effectiveness of triple, quadruple, and sequential antibiotic therapies for Helicobacter pylori (H. pylori) elimination.

Method

Overall, 296 subjects who tested positive for H. pylori were randomly assigned to get 1 of 3 treatment plans:

Group 1 received the standard triple therapy, which consisted of Esomeprazole 40 mg, Amoxicillin 1 g, and Clarithromycin 500 mg, taken twice daily for a duration of 14 days.
Group 2 received sequential antibiotic therapy, which involved taking Esomeprazole 40 mg twice daily for 10 days. For the first five days, participants took Amoxicillin 1 g twice daily. This was followed by Clarithromycin 500 mg twice daily, and then Tinidazole 500 mg twice daily for the residual five days. The total treatment duration was 10 days.
Group 3 received bismuth-based quadruple therapy, which included taking Esomeprazole 40 mg twice daily, Bismuth 120 mg four times daily, Tinidazole 500 mg twice daily, and Tetracycline 500 mg four times daily for a duration of 14 days.

Utilizing the H. pylori stool antigen test, the rate of elimination was evaluated.

Result

Among the 296 individuals who tested positive for H. pylori, 84, 86, and 84 volunteers concluded the follow-up in the quadruple therapy, standard triple therapy, and sequential therapy groups, respectively. The eradication rates for the study groups are depicted in Table 1:

Overall, compliance with the various treatment regimens was high, and most side effects were mild and did not result in therapy discontinuation.

Conclusion

The efficacy of 14-day standard triple therapy, 14-day bismuth-based quadruple therapy, and 10-day sequential therapy in eliminating H. pylori is comparable, with all regimens achieving optimal rates of elimination.

Source:

Indian Journal of Gastroenterology

Link:

https://link.springer.com/article/10.1007/s12664-022-01322-8

Article:

Comparison of the efficacies of triple, quadruple and sequential antibiotic therapy in eradicating Helicobacter pylori infection: A randomized controlled trial