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Bismuth-based quadruple therapy for Helicobacter pylori - a single triple capsule plus lansoprazole
W A De Boer1, R J Van Etten, B A Van De Wouw
1Department of Internal Medicine, Sint Anna Hospital, Oss, the Netherlands; Department of Gastroenterology, University of Nijmegen Radboud Hospital, Nijmegen, the Netherlands.
Background:
Recently a new 'all in one' single capsule with the three components of bismuth-based triple therapy became available in trials for treating Helicobacter pylori.
Aim:
To investigate the efficacy and tolerability of this new capsule when combined with lansoprazole.
Methods:
A total of 66 consecutive infected patients from a single centre received two single triple capsules four times daily and lansoprazole 30 mg b.d. for 7 days. Each capsule contained 60 mg of bismuth subcitrate, 125 mg of tetracycline and 125 mg of metronidazole. Endoscopy with biopsies for CLO-test, histology and culture from antrum and corpus was performed before and at least 5 weeks after treatment.
Results:
The per protocol cure rate was 56/64 (88%, 95% CI: 79-95%); by intention-to-treat 56/65 (86%, 95% CI: 78-95%). The per protocol cure rate in metronidazole sensitive strains was 40/43 (93%, 95% CI: 85-100%); in resistant strains 5/9 (56%, 95% CI: 23-88%). There was one drop-out due to adverse events.
Conclusions:
It is possible to combine the components of bismuth-based triple therapy into a single capsule. Based on the results it can be assumed that the capsule releases its content in the stomach. When combined with lansoprazole it reaches high cure rates, especially in metronidazole sensitive strains. This new approach simplifies bismuth-based anti-Helicobacter therapy.