TUESDAY, Feb. 22 (HealthDay News) -- Compared to standard therapy, quadruple therapy is better at eliminating Helicobacter pylori (H. pylori) infection in adults and should be considered as the first-line treatment in clarithromycin-resistant H. pylori, according to a study published online Feb. 22 in The Lancet.
Peter Malfertheiner, M.D., from the Otto-von-Guericke-Universtität in Magdeburg, Germany, and colleagues conducted a randomized phase 3 trial to compare the efficacy of 10 days of quadruple therapy (omeprazole plus a single three-in-one capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline) with seven days of standard therapy (omeprazole, amoxicillin, and clarithromycin) in adults with H. pylori infection. Absence of H. pylori infection, established by two negative urea breath tests 28 and 56 days after the end of treatment, was the primary end point of the study.
The researchers found that according to intention-to-treat analysis, the eradication rates of H. pylori were significantly higher in the quadruple therapy group, 80 percent (174 of 218 participants) versus 55 percent (123 of 222 participants), than in the standard therapy group. Both treatment groups had similar safety profiles with gastrointestinal and central nervous system disorders as the main adverse events.
"Our results show that 10 days of treatment with quadruple therapy yields H. pylori eradication rates superior to seven days of treatment with standard therapy," the authors write. "In regions with high levels of clarithromycin resistance, treatment with quadruple therapy should be considered as first-line therapy for H. pylori eradication."
Several study authors disclosed financial relationships with Axcan Pharma Inc., which also funded the study.
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