Related Experiment Video
Updated: Aug 14, 2026
Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
Efficacy and tolerability of antibiotics in patients undergoing H. pylori eradication
S Danese1, A Armuzzi, A Romano
1Internal Medicine Department, Gemelli Hospital, Catholic University, Rome, Italy.
Background/Aims:
Helicobacter pylori (H. pylori) infection is one of the most common gastrointestinal diseases. An increasing number of people undergo different treatment options. Unfortunately, H. pylori therapy may be troublesome for drug side effects and inefficacious for resistance to antibiotics.
Methodology:
One hundred and ninety-three (193) H. pylori-positive patients were randomly assigned to one of the following 7-day treatments: Group A (N = 64): amoxicillin, clarithromycin and rabeprazole; Group B (N = 64): tinidazole, clarithromycin and ranitidine bismuth citrate; Group C (N = 65): tinidazole, clarithromycin and rabeprazole Eradication was assessed by 13C-Urea Breath Test 6-8 weeks after the end of the therapy. Not-eradicated patients underwent a second cycle with tinidazole, tetracycline, bismuth and rabeprazole. All patients were asked to complete a validated questionnaire regarding presence and intensity of drug side effects.
Results:
One hundred and eighty-eight out of the 193 H. pylori-positive patients (96%) completed therapy. No significant difference in eradication rates was observed among the three groups both in intention to treat analysis and in per protocol analysis. No significant difference in incidence of side effects occurred among groups after the first-line regimens: 48% in group A, 44% in group B and 46% in group C. Twenty-two out of the 193 enrolled subjects (11%) were not eradicated after the first-line therapy. Among them, 86% were successfully eradicated by the tinidazole, tetracycline, bismuth and rabeprazole therapy. Moreover, during quadruple therapy, a higher prevalence and intensity of side effects than in each one of the groups submitted to the first-line triple therapy was observed.
Conclusions:
This study shows that triple rabeprazole-based eradicating regimens are effective and safe. Incidence of side effects seems low and similar in different three-drug regimens used. Quadruple therapy, which appear highly efficacious as a second line therapy, is associated with a significantly higher incidence of side effects when compared to first-line treatment.
Insights
Rabeprazole-based triple therapy effectively eradicates Helicobacter pylori with low side effects. Second-line quadruple therapy is also effective but causes more adverse events.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Helicobacter pylori infection is a common gastrointestinal disease.
- Treatment challenges include drug side effects and antibiotic resistance.
- Developing effective and safe eradication strategies is crucial.
Purpose of the Study:
- To compare the efficacy and safety of three different 7-day triple therapy regimens for H. pylori eradication.
- To evaluate the effectiveness of a second-line quadruple therapy for non-eradicated patients.
- To assess the incidence and intensity of drug side effects associated with each treatment regimen.
Main Methods:
- 193 H. pylori-positive patients were randomized into three groups receiving different triple therapies (amoxicillin/clarithromycin/rabeprazole; tinidazole/clarithromycin/ranitidine bismuth citrate; tinidazole/clarithromycin/rabeprazole).
- Eradication was confirmed using the 13C-Urea Breath Test.
- Non-eradicated patients received a second-line quadruple therapy (tinidazole/tetracycline/bismuth/rabeprazole).
- Patient-reported side effects were collected via a validated questionnaire.
Main Results:
- No significant difference in eradication rates was found among the three first-line triple therapy groups (96% overall completion).
- Side effect incidence was similar across the first-line groups (44-48%).
- Second-line quadruple therapy achieved an 86% eradication rate in non-responders but was associated with higher side effect prevalence and intensity.
Conclusions:
- Rabeprazole-based triple therapy regimens are effective and safe for H. pylori eradication.
- First-line triple therapies demonstrate comparable efficacy and low, similar side effect profiles.
- While effective, second-line quadruple therapy presents a higher burden of side effects compared to initial treatments.
More Related Videos
05:23Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
04:56Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Related Concept Videos
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
01:28Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
01:24Peptic Ulcer Disease II: Pathophysiology