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Quadruple therapy for Helicobacter pylori ‘should be first line’


Quadruple antibiotic therapy should be considered first-line treatment for Helicobacter pylori infection, say researchers.

The team demonstrated greater efficacy at treating H. pylori using combination therapy with omeprazole plus a single three-in-one capsule containing bismuth subcitrate potassium, metronidazole and tetracycline than triple therapy with omeprazole, amoxicillin and clarithroymcin.

For the Phase III study, 440 adults with predetermined H. pylori infection were randomly assigned to receive 10 days’ quadruple or seven days’ triple therapy.

Helicobacter pylori is associated with malignancy in the upper gastrointestinal tract, and increasing antibiotic resistance of the bacteria has made alternative treatments necessary.

Eradication rates in the current trial were significantly higher (p<0.0001) in the quadruple than the triple therapy group.

Lead author Prof Malfartheiner concluded: “Quadruple therapy should be considered for first-line treatment in view of the rising prevalence of clarithromycin-resistant H pylori.”

The Lancet 2011

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