Efficacy of quadruple therapies as second-line regimens for eradication of Helicobacter pylori

AIM: To determine efficacy of two quadruple therapies as second line regimens for eradication of Helicobacter pylori (Hp) . METHODS: One hundred and eight patients who had failed eradication after proton pump inhibitor (PPI) based triple therapy or had relapsed after eradication, were divided into two groups. Group A ( n =54, M 44, F 10; age 61 a± s 13 a) were treated for 1 wk with omeprazole 20 mg, colloidal bismuth subcitrate 240 mg, metronidazole 400 mg po , bid, tetracycline 500 mg po , qid. Group B( n =54, M 43, F 11; age 62 a±17 a) were treated for 1 wk with omeprazole 20 mg, colloidal bismuth subcirate 240 mg, amoxicillin 1 000 mg, metronidazole 400 mg, po , bid. One month after anti Hp therapy, tests of Hp were repeated. RESULTS: One patient was lost to follow up in group A and group B, respectively. Two patients in group A and one patient in group B stopped treatment because of adverse reactions. On the per protocol analysis, eradication rates of Hp were 82 % in group A and 81 % in group B. On the Intention to treat analysis, eradication rates of Hp were 78 % in group A and in group B, respectively. Adverse reaction rates were 23 % in group A and 11 % in group B. The results between group A and group B showed no significant difference. CONCLUSION: The two quadruple therapies as second line regimens for eradication of Hp are highly effective and without severe adverse reactions.