Bismuth quadruple therapy (BQT) is an effective treatment for Helicobacter pylori infection. However, frequent dosing schedules of BQT regimen often compromise drug adherence and may affect treatment outcomes. This retrospective study aimed to investigate the efficacy of twice-daily BQT compared to that of four times a day therapy. From August 2018 to November 2020, adult patients who failed first-line standard triple therapy and underwent BQT were eligible. Patients were categorized into two groups according to dosing schedule: (i) the BQT group (n = 213) who received standard BQT administered four times a day; and (ii) the BQTb group (n = 141) who received proton pump inhibitor, bismuth 600 mg, metronidazole 500 mg, and tetracycline 1 g twice a day. The eradication rate did not differ between the BQT (92.5%) and the BQTb groups (90.1%) (p = 0.441). Adherence and adverse event rate were similar between the two groups. Multivariate analysis showed that current smoking was associated with eradication failure; however, dosing frequency was not associated with the efficacy of eradication therapy. This study suggested that twice a day BQT is as effective as four times a day therapy for second-line treatment of H. pylori infection.

The optimal timing of endoscopy in patients with acute upper gastrointestinal bleeding (UGIB) remains controversial. In this study, we investigated the clinical outcomes of urgent endoscopy in patients with symptoms suggestive of UGIB compared with elective endoscopy.From January 2016 to December 2018, consecutive patients who visited the emergency department and underwent endoscopy for clinical manifestations of acute UGIB were eligible. Urgent endoscopy (within 6 hours) and elective endoscopy (after 6 hours) were defined as the time taken to perform endoscopy from presentation to the emergency department. The primary outcome was mortality rate within 30 days.A total of 572 patients were included in the analysis. Urgent endoscopy was performed in 490 patient. The 30–day mortality rate did not differ between the urgent endoscopy group and the elective endoscopy group. There was no difference regarding the recurrent bleeding rate, total amount of transfusion, and length of hospital stay in both groups. In multivariate analysis, age and the amount of transfusion were factors associated with mortality.Urgent endoscopy was not associated with lower 30–day mortality rate compared with elective endoscopy in patients with suspected of acute UGIB.