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Limited usefulness of a seven-day twice-a-day quadruple therapy
1Department of Surgery, Corporació Sanitària Parc Tauli, Sabadell, Spain.
Objective:
To test the usefulness of a twice-a-day, simplified quadruple therapy to cure Helicobacter pylori infection.
Design:
Helicobacter pylori-positive ulcer patients were treated with omeprazole 20 mg twice a day (b.d.), amoxicillin 1 g b.d., tinidazole 500 mg b.d. and bismuth subcitrate 240 mg b.d. for 7 days in an experimental, noncomparative pilot study.
Setting:
The gastroenterology unit of a county hospital.
Participants:
Forty-four consecutive patients with peptic ulcer disease and H. pylori infection.
Measurements:
Cure was tested by either endoscopy or breath test after 2 months, and by urea breath test 6 months after therapy.
Results:
One patient was lost to follow-up. Of the remaining 43, 37 were cured at the first control, giving an intention-to-treat cure rate of 84.1% (95% CI 69-93%) and a per protocol cure rate of 86% (95% CI 71-94%). Thirty-three cured patients agreed to return for a six-month breath test. All but one were cured (long-term per protocol cure rate 82.1%; 95% CI 66-92%).
Conclusions:
This particular quadruple therapy is well tolerated and easy to comply with. However, cure rates did not reach 90%.