First-line Bismuth-containing Five-day Concomitant Quintuple Therapy for Helicobacter Pylori Eradication

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Rising antibiotic resistance necessitates novel Helicobacter pylori (H. pylori) eradication strategies.
• Traditional therapies face declining efficacy due to H. pylori resistance.
• Novel therapeutic options are crucial for effective H. pylori treatment.

Purpose of the Study:

• To evaluate the efficacy and tolerability of a 5-day bismuth-containing quintuple therapy for first-line H. pylori eradication.
• To assess patient compliance with the short-course quintuple therapy regimen.
• To determine the effectiveness of this regimen in a population with potential antibiotic resistance.

Main Methods:

• Prospective study of 144 H. pylori-positive, treatment-naïve patients with dyspepsia.
• Administered 5-day concomitant quintuple therapy: bismuth, omeprazole, clarithromycin, amoxicillin, and metronidazole.
• Assessed eradication using stool antigen or urea-breath tests 6 weeks post-therapy.

Main Results:

• High treatment compliance rate of 97.2%.
• Intention-to-treat eradication rate of 93.1% (134/144).
• Per-protocol eradication rate of 95.7% (134/140).
• Low incidence of side effects (8.5%), including mild gastrointestinal symptoms and fatigue.

Conclusions:

• Short-course, bismuth-containing quintuple therapy is effective for first-line H. pylori eradication.
• The regimen demonstrates good tolerability and high patient compliance.
• This therapy is a viable option for H. pylori eradication, particularly in areas with high antibiotic resistance.