Two-Day Quadruple Therapy for Cure of Helicobacter pylori Infection: A Comparative, Randomized Trial

Abstract

Two-day quadruple therapy is significantly less effective than 2-wk triple treatment.

Addition of Metronidazole to Rabeprazole‐Amoxicillin‐Clarithromycin Regimen for Helicobacter pylori Infection Provides an Excellent Cure Rate with Five‐Day Therapy

“…Among these studies, 7-day PPI plus standard bismuth triple therapy, which is now termed quadruple therapy , provides a consistently high eradication rate (approximately 96%) [10,16]. Several short-duration regimens for cure of H. pylori infection have been reported [2,3,[18][19][20][21][22][23][24]. Furthermore, this therapy has fewer adverse effects than commonly observed with 14-day bismuth triple therapy [17].…”

“…Two-day quadruple regimens have been reported [21,22]. One, consisting of omeprazole, amoxicillin, metronidazole, and bismuth for 2 days followed by omeprazole for 6 additional days, resulted in a cure rate of 69% by ITT and 71% by PP analysis [21].…”

Optimization strategies aimed to increase the efficacy of H. pylori eradication therapies

“…75 Therefore, to obtain maximal pharmacodynamic effect, prescribing amoxicillin in smaller and more frequent doses (eg, three or four times daily) has been suggested to improve efficacy. 75 Therefore, to obtain maximal pharmacodynamic effect, prescribing amoxicillin in smaller and more frequent doses (eg, three or four times daily) has been suggested to improve efficacy.…”

Meta‐analysis: the efficacy, adverse events, and adherence related to first‐line anti‐Helicobacter pylori quadruple therapies

“…The gastric acid inhibitor, bismuth, a nitroimidazole, and amoxicillin (GBNA) regimen was used in 10 studies with 12 treatment arms and 629 patients from Spain, Italy, Iran, Finland, the United States and China (Table 1). [68][69][70][71][72][73][74][75][76][77] The majority of the treatment arms used metronidazole instead of tinidazole (83%), omeprazole for acid inhibition (67%), and came from articles published in peer-reviewed journals (83%), and randomized-clinical trials (67%); 25% used ranitidine for acid inhibition. Treatment was given for fewer than 4 days in 33% of the treatment arms; the most common treatment duration was 7 days (42%, five treatment arms).…”