The Efficacy of Quadruple Therapy Versus Triple Therapy in Helicobacter pylori Eradication

Background and aims Helicobacter pylori (H. pylori) is a significant cause of various gastrointestinal diseases, including gastritis, peptic ulcers, and even stomach cancer. Therefore, eradication is essential to prevent these conditions and their associated complications. The emergence of antibiotic-resistant strains and the lack of sufficient data on antibiotic sensitivity have made it increasingly challenging to treat H. pylori, which has led to the emergence of various regimens. This article will compare the efficacy of different regimens to provide insights into the most effective treatment options for H. pylori. Methods Our study is a retrospective, single-center study that reviews the data of 1,246 outpatients who were diagnosed with H. pylori infection and underwent testing to confirm eradication of H. pylori after receiving the therapeutic regimen. Patients received one of the following regimens: clarithromycin-based triple therapy (CT), levofloxacin-based triple therapy (LT), or bismuth-based quadruple therapy (BT). Results In total, 1,246 individuals were treated with different regimens, resulting in an overall success rate of 69.3%. The success rates of the triple and quadruple therapies were comparable, with 67.7% and 74.3%, respectively. When looking at individual treatment regimens, BT had the highest success rate at 74.3%, followed by CT with 67.9% and LT with 64.8%. Conclusion In Bahrain, BT demonstrates greater effectiveness compared to commonly used triple therapies. Despite this, the overall eradication rate remains low, indicating a significant presence of resistance within the population. Therefore, it is crucial to emphasize the need for sensitivity testing to develop local antibiograms and ensure cost-effectiveness.