This site is intended for health professionals only


H pylori therapy better than gold standard

By Lilian Anekwe

Quadruple therapy with a proton-pump inhibitor plus a single three-in-one capsule is better than the gold-standard treatment regimen of omeprazole, amoxicillin, and clarithromycin in adults with Helicobacter pylori infection, a new trial has shown.

Researchers randomised adult patients in 39 European countries with recorded H pylori infection either a 10-day course of a new triple combination therapy of bismuth subcitrate potassium, metronidazole, and tetracycline prescribed along with omeprazole, or a seven-day course of standard therapy.

Eradication rates were evaluated by two negative 13C urea breath tests at a minimum of 28 and 56 days after the end of treatment.

In an intention-to-treat population of 440 patients, quadruple therapy had a significantly higher eradication rate, at 80%, than standard therapy, at 55%.

Severe treatment-emergent adverse events including dyspepsia, upper abdominal pain, headache and generalised infection were occurred in 5% of the quadruple therapy groups compared with 7% of the standard therapy group.

Professor Peter Malfertheiner, professor of gastroenterology and hepatology at Otto-von-Guericke University in Magdeburg, Germany, concluded: ‘Quadruple therapy should be considered for first-line treatment in view of the rising prevalence of clarithromycin-resistant H pylori, especially since it provides superior eradication with similar safety and tolerability to standard therapy.'

The Lancet, published online February 22


          

Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.