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. 2021 Apr 29:12:667584.
doi: 10.3389/fphar.2021.667584. eCollection 2021.

Single Capsule Bismuth Quadruple Therapy for Eradication of H. pylori Infection: A Real-Life Study

Antonietta G Gravina  1 , Kateryna Priadko  1 , Lucia Granata  1 , Angela Facchiano  1 , Giuseppe Scidà  1 , Rosa Cerbone  1 , Paola Ciamarra  1 , Marco Romano  1
Affiliations

Single Capsule Bismuth Quadruple Therapy for Eradication of H. pylori Infection: A Real-Life Study

Antonietta G Gravina et al. Front Pharmacol. .

Abstract

Background and aim: Bismuth quadruple therapy (BQT) or non-bismuth quadruple therapy (i.e., concomitant therapy) (CT) is the first-line regimens to eradicate H. pylori infection in areas with high prevalence of clarithromycin (CLA) resistance. Guidelines suggest that in areas of high prevalence of H. pylori strains with double resistance (i.e., CLA + metronidazole), BQT should be preferred to CT. The aim of this study was to evaluate the efficacy and safety of BQT administered through the three-in-one pill (Pylera) formulation in a large series of H. pylori-infected patients, naive to treatment in a region with high CLA and dual resistance. Patients and methods: We treated 250 patients (148 F and 102 M, mean age 48.6 years) with H. pylori infection naïve to treatment. Patients received esomeprazole 40 mg bid and Pylera 3 tablets qid for 10 days. Diagnosis of H. pylori infection was through 13C urea breath test (13C UBT), or stool antigen test or histology, as appropriate. The evaluation of eradication was through 13C UBT at least 45 days after the end of therapy. Incidence of treatment-related adverse events (TRAEs) was assessed through a questionnaire at the end of treatment. Compliance was considered good if at least 90% of medication had been taken. Statistical analysis was per intention-to-treat e per protocol (PP). 95% confidence intervals (CIs) were calculated. Results: 1) 13 patients (5.2%) discontinued therapy due to side effects; 2) eradication rates in ITT and PP were 227/250 (90.8%; 95% CI 86.3-93.7%) and 226/237 (95.3%; 95% CI 91-99%), respectively; 3) the prevalence of TRAEs was 26.8%; and 4) adherence to treatment was good with compliance greater than 90%. Conclusion: In this real-life study, we demonstrate that in an area with a high prevalence of H. pylori strains with CLA or CLA + metronidazole resistance, BQT using Pylera is an effective therapeutic strategy with ITT eradication rates higher than 90%; this therapy is associated with good compliance and low incidence of side effects.

Keywords: BQT; H. pylori; bismuth quadruple therapy; eradication therapy; real life.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of the study.
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References

    1. Baldwin C. M., Keam S. J. (2009). Rabeprazole: a review of its use in the management of gastric acid-related diseases in adults. Drugs 69 (10), 1373–1401. 10.2165/00003495-200969100-00007 - DOI - PubMed
    1. Boparai V., Rajagopalan J., Triadafilopoulos G. (2008). Guide to the use of proton pump inhibitors in adult patients. Drugs 68 (7), 925–947. 10.2165/00003495-200868070-00004 - DOI - PubMed
    1. Calvet X., Gomoll ó n F. (2005). What is potent acid inhibition, and how can it be achieved? Drugs 65 (Suppl. 1), 13–23. 10.2165/00003495-200565001-00004 - DOI - PubMed
    1. De Francesco V., Margiotta M., Zullo A., Hassan C., Valle N. D., Burattini O., et al. (2006). Claritromycin resistance and Helicobacter pylori genotypes in Italy. J. Microbiol. 44 (6), 660–664. - PubMed
    1. Di Ciaula A., Scaccianoce G., Venerito M., Zullo A., Bonfrate L., Rokkas T., et al. (2017). Eradication rates in Italian subjects heterogeneously managed for Helicobacter pylori infection. Time to abandon empiric treatments in Southern Europe. Jgld 26 (2), 129–137. 10.15403/jgld.2014.1121.262.itl - DOI - PubMed

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