Euroasian journal of hepato-gastroenterology

Register      Login

VOLUME 2 , ISSUE 2 ( July-December, 2012 ) > List of Articles


Efficacy of Bismuth-Containing Quadruple Therapy as First-line Treatment for Helicobacter pylori Infection

Metin Küçükazman, Ayse Kefeli, Sebahat Basyigit, Abdullah Özgür Yeniova, Yasar Nazligül, Ibrahim Halil Akkus, Ayla Tezer, Servet Guresci

Citation Information : Küçükazman M, Kefeli A, Basyigit S, Özgür Yeniova A, Nazligül Y, Halil Akkus I, Tezer A, Guresci S. Efficacy of Bismuth-Containing Quadruple Therapy as First-line Treatment for Helicobacter pylori Infection. Euroasian J Hepatogastroenterol 2012; 2 (2):90-93.

DOI: 10.5005/jp-journals-10018-1041

License: CC BY-NC 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2012; The Author(s).


Background and aim: Helicobacter pylori (H. pylori) infection can cause chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. For this reason, eradication of H. pylori has become an important issue. In recent years, failure of eradication therapy with standard eradication regimes had directed toward new therapeutic alternatives. The present study aimed to show the efficacy of bismuth-containing quadruple regimen for the first-line treatment of H. pylori infection. Materials and methods: H. pylori positive patients received a quadruple therapy consisted of esomeprazole 20 mg bid, colloidal bismuth subcitrate 600 mg bid, tetracycline 500 mg qid and metronidazole 500 mg tid for 7 days. The diagnosis of H. pylori infection was performed by the histopathological assessment of gastric biopsies. Six weeks after completion of therapy, H. pylori status was rechecked by C14 urea-breath test. Results: A total of 115 patients have completed the protocols (upper gastrointestinal endoscopy, treatment, urea-breath test). H. pylori eradication rate was found to be 87%. This eradication rate is significantly higher than those of classic triple therapies in the literature. Conclusion: The bismuth-containing quadruple regimen achieved an acceptable and very higher eradication rate than those of classic triple therapies in the literature. It can recommend as a first-line therapy for Helicobacter pylori infection.

PDF Share
  1. van Duynhoven YT, de Jonge R. Transmission of Helicobacter pylori: A role for food? Bull World Health Organ 2001;79: 455-60
  2. Current concepts in the management of Helicobacter pylori infection: The Maastricht III Consensus Report. GUT 2007;56:772-81
  3. Eradication of Helicobacter pylori with triple therapy: An epidemiologic analysis of trends in Turkey over 10 years. Clin Ther 2006;28:1960-66
  4. Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey. World J Gastroenterol 2004;10:668-71
  5. Can lansoprazole, amoxicillin, and clarithromycin combination still be used as a first-line therapy for eradication of Helicobacter pylori? Turk J Gastroenterol 2005;16:29-33
  6. High Helicobacter pylori resistance rate to clarithromycin in Turkey. J Clin Gastroenterol 2007;41:747-50
  7. Geographic map and evolution of primary Helicobacter pylori resistance to antibacterial agents. Expert Rev Anti Infect Ther 2010;8:59-70
  8. European Helicobacter Pylori Study Group (EHPSG). Current concepts in the management of Helicobacter pylori infection—the Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther 2002;16:167-80
  9. Treatment of Helicobacter pylori infection: A review of the world literature. Helicobacter 1996;1:6-19
  10. Meta-analysis: The efficacy, adverse events, and adherence related to first-line anti- Helicobacter pylori quadruple therapies. Aliment Pharmacol Ther 2004;20:1071-82
  11. Second Asia-Pacific Conference. Second Asia-Pacific Consensus Guidelines for Helicobacter pylori infection. J Gastroenterol Hepatol 2009;24: 1587-600
  12. Antibiotic resistance rates of Helicobacter pylori isolates and the comparison of E-test and fluorescent in situ hybridization methods for the detection of clarithromycin resistant strains. Mikrobiyol Bul 2009;43(2): 227-34
  13. Triple or quadruple tetracycline-based therapies versus standard triple treatment for Helicobacter pylori treatment. Am J Med Sci 2009; 338:50-53
  14. The efficacy of bismuth containing quadruple therapy as a first-line treatment option for Helicobacter pylori. J Dig Dis 2007;8: 211-15
  15. Efficacy of the standard quadruple therapy versus triple therapies containing proton pump inhibitor plus amoxicillin and clarithromycin or amoxicillin-clavulanic acid and metronidazole for Helicobacter pylori eradication in children. Dig Dis Sci 2009; 54:1720-24
  16. Treatment of Helicobacter pylori in surgical practice: A randomised trial of triple versus quadruple therapy in a rural district general hospital. World J Gastroenterol 2008;14:3855-60
  17. Effectiveness and safety of proton pump inhibitor and levofloxacin based first-line triple therapy in the eradication of Helicobacter pylori: A meta-analysis. Zhonghua Yi Xue Za Zhi 2008;88:2722-25
  18. Moxifloxacin-based strategies for first-line treatment of Helicobacter pylori infection. Aliment Pharmacol Ther 2005;21:1241-47
  19. Low efficacy rate of moxifloxacin-containing Helicobacter pylori eradication treatment: In an observational study in a Turkish population. Helicobacter 2007;12:518-22
  20. Sequential therapy vs standard triple therapies for Helicobacter pylori infection: A meta-analysis. J Clin Pharm Ther 2009;34:41-53
  21. Comparison of sequential and standard triple-drug regimen for Helicobacter pylori eradication: A 14-day, open-label, randomized, prospective, parallel-arm study in adult patients with nonulcer dyspepsia. Clin Ther 2008;30:528-34
  22. A pilot study evaluating sequential administration of a PPI-amoxicillin followed by a PPI-metronidazole-tetracycline in Turkey. Helicobacter 2007;12:629-32
  23. Cross resistance between rifampin and rifabutin. Respir Dis 2000; 11:396-400. Efficacy of Bismuth-Containing Quadruple Therapy as First-line Treatment for Helicobacter pylori Infection Euroasian Journal of Hepato-Gastroenterology, July-December 2012;2(2):90-93 93 EJOHG 24. Senol G, Erbayci A, Ozsoz A. Incidence of cross-resistance between rifampin and rifabutin against Mycobacterium tuberculosis isolates. Klimik Journal 2004;17:124-27
  24. ‘Rescue’ regimens after Helicobacter pylori treatment failure. World J Gastroenterol 2008;14:5385-402
  25. Systematic review and metaanalysis: Proton pump inhibitor vs ranitidine bismuth citrate plus two antibiotics in Helicobacter pylori eradication. Helicobacter 2005;10:157-71
  26. Review article: Treatment of Helicobacter pylori infection with ranitidine bismuth citrate- or proton pump inhibitor-based triple therapies. Aliment Pharmacol Ther 2000;14:991-99.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.