One-week triple vs. quadruple therapy for Helicobacter pylori infection — a randomized trial

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Abstract

Background:

Seven-day triple therapy including omeprazole, clarithromycin and amoxicillin has become the treatment of choice for Helicobacter pylori infection. However, 7 days of classical quadruple therapy combining omeprazole, tetracycline, metronidazole and bismuth may be an alternative to triple therapy.

Aim:

To compare triple vs. quadruple therapy for H.pylori eradication.

Methods:

Three hundred and thirty-nine patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomized to receive omeprazole,20 mg, amoxicillin, 1 g, and clarithromycin, 500 mg, all b.d., or omeprazole, 20 mg b.d., tetracycline chloride, 500 mg, metronidazole, 500 mg, and bismuth subcitrate, 120 mg, all t.d.s. Cure was defined as a negative urea breath test at least 2 months after treatment.

Results:

Per protocol and intention-to-treat cure rates were 86%[95% confidence interval (CI), 80–91%] and 77% (95% CI, 70–83%) for triple therapy, and 89% (95% CI, 82–93%) and 83% (95% CI, 76–88%) for quadruple therapy. No significant differences between the groups were found in the cure rates, compliance or side-effects.

Conclusion:

One-week triple and quadruple therapy show similar results when used as first-line eradication treatment.

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