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Updated: Dec 13, 2025
Author Spotlight: Detection and Treatment of Helicobacter pylori Infection
Published on: July 28, 2023
High Effectiveness of a 14-Day Concomitant Therapy for Helicobacter pylori Treatment in Primary Care. An
Llum Olmedo1,2, Rafael Azagra2,3,4, Amada Aguyé3,5
1ABS Manresa 3, Althaia, Xarxa Assistencial de Manresa, Programa de Doctorado en Ciencias de la Salud, Universitat Internacional de Catalunya, 08243 Barcelona, Spain.
Background:
The current cure rates with triple therapy combining a proton-pump inhibitor, amoxicillin and clarithromycin are unacceptably low.
Aims:
To evaluate the efficacy of a 14-day concomitant therapy as an empirical first-line treatment for curing Helicobacter pylori (Hp) infection in primary care.
Methods:
Patients from six primary care centers in Catalonia -Spain- were included consecutively. Hp status pre and post treatment was assessed according to local clinical practice protocol. A 14-day concomitant therapy (amoxicillin 1 g, clarithromycin 500 mg and metronidazole 500 mg plus omeprazole 20 mg, all drugs administered twice daily) was prescribed. Adherence to therapy and adverse events were assessed by personal interview.
Results:
112 patients were enrolled. Mean age was 46.7 ± 16.1 years. Main indication for treatment was non-investigated dyspepsia (83%). Hp eradication was achieved in 100 of the 112 patients. Eradication rates were 89.3% (95% CI: 81.7-94.1) by intention-to-treat (ITT) analysis and 91.7% (95% CI; 84.6-95.9) per protocol (PP). No major side effects were reported; 104 (92.8%) patients complete the treatment. Forty-seven patients (42%) complained of mild side effects (metallic taste, nausea). Low adherence to treatment (p = 0.004) and significant adverse events (p = 0.004) were the variables associated with treatment failure.
Conclusions:
In primary care, a 14-day concomitant therapy is highly effective and well tolerated.
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