Optimized Bismuth Quadruple Therapy vs Triple Standard Therapy for Helicobacter Pylori Eradication

Summary

This study have as primary aim "To compare the H. pylori eradication rate between the quadruple bismuth therapy versus the standard triple therapy recommended by the AUGE Clinical Guidelines for Helicobacter pylori eradication treatment in peptic ulcer patients." Briefly, this is a randomized, multicenter, controlled, double-blind clinical trial with two parallel arms. The control group will receive the current Standard Triple Therapy for the eradication of H. pylori. It consists of omeprazole + amoxicillin + clarithromycin for 14 days. The intervention group will be administered Quadruple Therapy with Bismuth, which consists in esomeprazole + amoxicillin + metronidazole + bismuth subsalicylate for 14 days

Timeline

Start

2022-10-17

Primary completion

2023-10-30

Completion

2024-01-30

Outcome

Met primary endpoint

paper significantly higher eradication rate versus standard triple therapy: 95% (60/63) [95% CI 86%-99%] vs. 81% (52/64) [70%-89%], p = 0.033. PMID 41362749 ↗

Publications

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• Medel-Jara PA, Latorre G, Fuentes-Lopez E, Pizarro M, Viviani P, Chahuan J, Maquilon S, Corsi O, Reyes D, Espino A, Vargas JI, Wichmann IA, Harris P, Serrano C, Buruato I, Sandoval C, Varela NM, Cerpa L, Quinones L, Megraud F, Huang RJ, Shah SC, Perez AR. Comparison between optimized bismuth quadruple therapy and standard clarithromycin-based triple therapy for first-line Helicobacter pylori eradication: a double-blind randomized controlled trial. Lancet Reg Health Am. 2025 Nov 22;53:101312. doi: 10.1016/j.lana.2025.101312. eCollection 2026 Jan.

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