The following is a summary of “Eradication efficacy of high-dose amoxicillin and proton pump inhibitor compared with quadruple therapy contained bismuth in the treatment of Helicobacter pylori,” published in the December 2022 issue of Primary care by Hajiani, et al.


One of the most widespread bacterial illnesses that affect people all over the world is Helicobacter pylorus. Nonsteroidal anti-inflammatory drug usage and H. pylori are the two main causes of peptic ulcer disease. For a study, researchers sought to compare two antibiotic treatment plans for H. pylori.

The randomized clinical trial linked to the gastrointestinal clinic at Imam Khomeini Hospital, Ahvaz, involved 220 H. pylori-infected patients. Patients were divided randomly into two groups. The bismuth-containing quadruple therapy was administered to group II, while group I received the 14-day proton pump inhibitor (PPI) amoxicillin-containing high-dose therapy. Fundamental traits, negative incidents, and eradication rates were contrasted between the two groups.

With regard to the intention-to-treat and per-protocol analyses, the PPI-amoxicillin-containing high-dose treatment group attained eradication rates of 73.6% and 72.4%, respectively (P > 0.05). On the other hand, the eradication rates in the triple therapy group that contained bismuth were 77.2% and 76.1%, respectively (P > 0.05). Also, the two groups had no appreciable variations in the compliance rates and negative effects (P > 0.05). Additionally, compared to the quadruple therapy that includes bismuth, the cost of the drugs in the PPI-amoxicillin-containing high-dose therapy was much cheaper.

Because it was safer and less expensive than bismuth-containing quadruple therapy, PPI-amoxicillin-containing high-dose treatment regimens could be used, particularly in pregnant and breastfeeding patients and low-income patients.

Reference: journals.lww.com/jfmpc/Fulltext/2022/12000/Eradication_efficacy_of_high_dose_amoxicillin_and.39.aspx