Efficacy of tetracycline-based quadruple therapy as first-line treatment for eradication of Helieobaeter pylori infection

AIM To observe the efficacy and safety of 7 days of quadruple therapy with esomeprazole plus bismuth subcitrate potassium,metronidazole,and tetracycline(quadruple therapy) as first-line treatment for Helicobacter pylori(Hp) eradication in adults.METHODS A total of 148 out-patients with recorded Hp infection were assigned to trial group and control group.The patients in the trial group(n = 74) were treated with 7 days of quadruple therapy,and the patients in the control group(n = 74) were treated with 7 days of nexium,amoxicillin and clarithromycin(standard therapy).Four and eight weeks after the treatment,~(14)C-urea breath test and urease test was performed to determine the effect of Hp eradication.RESULTS Ten participants were lost to follow-up.In the perprotocol population(n = 138),eradication rates were 91%(62 of 68 participants) in the trial group versus 61%(42 of 69 participants) in the control group(P0.01).Main adverse reactions were similar between the two groups(P0.05).CONCLUSION Quadruple therapy should be considered for first-line treatment in the areas of the rising prevalence of clarithromycin-resistant and metronidazole-resistant Hp.