Published online Dec 14, 2019. doi: 10.3748/wjg.v25.i46.6790
Peer-review started: October 30, 2019
First decision: November 9, 2019
Revised: December 1, 2019
Accepted: December 7, 2019
Article in press: December 7, 2019
Published online: December 14, 2019
Helicobacter pylori (H. pylori) is becoming resistant to previously efficacious antibiotic regimens, including clarithromycin. The eradication rate afforded by legacy triple therapy (LTT), which includes clarithromycin, has declined over the past decade.
Many studies have explored the efficacy of first-line alternatives to LTT. However, only a few studies on the efficacy of bismuth-containing quadruple therapy (BCQT) and concomitant therapy (CT) have been conducted.
To determine the eradication rates of H. pylori and compare adverse events and compliance in groups of patients who received modified BCQT (mBCQT) and CT regimens.
We performed a prospective, open-label, randomized controlled trial with 2-week mBCQT and CT regimens.
Both mBCQT and CT regimens were effective on intention-to-treat and per-protocol analysis. Most patients showed good compliance. More CT than mBCQT patients experienced adverse events.
Both mBCQT and CT proved to be useful empirical first-line treatment options for H. pylori eradication in an area exhibiting high-level clarithromycin resistance
A large-scale prospective study is required to validate mBCQT and CT as empirical first-line treatment options for H. pylori eradication. The effects of treatment duration on eradication rates and side effects should be studied in future.