Background Helicobacter pylori (H. pylori) is a bacterium that produces dyspeptic syndrome with nausea, gastric or duodenal ulcers, even gastric cancer. The risk is higher in patients who have hepatitis with C virus associated.¹

There are several treatment regimens consisting of the combination of a double-dose gastric antisecretory with two or three antibiotics for a duration of 10 to 14 days.

Purpose To assess the efficacy and adverse events between eradication treatment for H. pylori with quadruple therapy A with amoxicillin 1 g/day, clarithromycin 1 g/day, metronidazole 500 mg/day and esomeprazole 40 mg/day for 10 days and quadruple therapy B with levofloxacin 500 mg/day, amoxicillin 1 g/day, bismuth oxide 480 mg/day and esomeprazole 40 mg/day for 10 days.

Material and methods This prospective study included 85 consecutive patients with dyspeptic syndrome who presented with H. pylori infection diagnosed by endoscopy and rapid urease test, divided in two groups: group A – 40 patients treated with quadruple therapy A; and group B – 45 patients treated with quadruple therapy B for 10 days. The eradication of infection was defined as a negative rapid urease test at 8 weeks after completion of treatment.

Results The eradication rate of H. pylori in group A was 77.5% (31 patients) and adverse events were presented in 30% (12 patients). In three cases (7.5%) the treatment was stopped because of severe digestive adverse effects. In Group B the eradication rate was 77.77% (35 patients) and the incidence of adverse effects was only 13.33% (six patients). In this group all the patients finished the therapy. The main adverse effects were digestive, such as as nausea, vomiting and food intolerance. However, there was not a significant difference in the H. pylori eradication rate between the two therapies (p=0. 999).

Conclusion The eradication rate of H. pylori is similar in therapy based on clarithromycin and metronidazole compared with the therapy based on bismuth and quinolones. The advantages of therapy based on bismuth and quinolones are a better tolerance and a decreased incidence of adverse effects.

References and/or Acknowledgements 1. Docea AO, Gofiă E, Călina D, Zaharie SI, Vâlcea DI, Mitru P. Autoimmune disorders due to double antiviral therapy with Peginterferon and Ribavirin in patients with hepatitis C virus infection. Farmacia2016;64(4):605–611.

No conflict of interest