Comparison of Hybrid and Bismuth Quadruple Therapies for Helicobacter Pylori Eradication
Comparison of Hybrid and Bismuth Quadruple Therapies for Helicobacter Pylori Eradication
According the Maastricht IV consensus report publish in the Gut 2012, bismuth containing
 quadruple therapy was suggested to be the first choice for eradication therapy of
 Helicobacter pylori in the area with high clarithromycin resistance. Whether hybrid therapy
 or 14-day bismuth containing quadruple therapy can replace standard triple therapy as the
 recommended first-line treatment is unknown. The investigators compared the efficacy of
 14-day hybrid therapy and 14-day bismuth containing quadruple therapy in first-line
 treatment.
For this randomly assigned to receive either a 14-day hybrid therapy (a dual therapy with
 pantoprazole 40 mg bid, amoxicillin 1 g bid for 7 days, followed by a quadruple therapy with
 pantoprazole 40 mg bid, amoxicillin 1 g bid, clarithromycin 500 mg bid, and metronidazole 500
 mg bid for a further 7 days) or a 14-day bismuth containing quadruple therapies (pantoprazole
 40 mg bid , bismuth subcitrate 120 mg qid., tetracycline 500 mg qid, and metronidazole 250 mg
 qid for 14 days).at a 1:1 ratio. Our primary outcomes was the eradication rate by
 intention-to-treat and per- protocol analyses
Inclusion Criteria:

 -  Consecutive H pylori-infected outpatients, at least 20 years of age, with
 endoscopically proven peptic ulcer diseases or gastritis

 Exclusion Criteria:

 -  previous H pylori-eradication therapy

 -  ingestion of antibiotics or bismuth within the prior 4 weeks

 -  patients with allergic history to the medications used

 -  patients with previous gastric surgery

 -  the coexistence of serious concomitant illness (for example, decompensated liver
 cirrhosis, uremia)

 -  pregnant women