Trial reportDigestive diseases and sciences2014
Third-line rescue therapy with bismuth-containing quadruple regimen after failure of two treatments (with clarithromycin and levofloxacin) for H. pylori infection.
Trial report in Digestive diseases and sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Third-line and rescue therapy for refractoryWorld journal of gastroenterology · 2023Pooled it
- Pooled it
- Exploration of the Interaction Between Bismuth-Containing Quadruple Anti-Microorganisms · 2026Article
- A Malaysian consensus report on the diagnosis and treatment ofJGH open : an open access journal of gastroenterology and hepatology · 2023Review
- Rescue therapy for refractoryTherapeutic advances in gastroenterology · 2023Review
- Treatment of RefractoryGut and liver · 2022Review
- Two-dimension Tailor-made Therapy: A New Salvage Therapy After Multiple Eradication Failures forGastro hep advances · 2022Article
- Single Capsule Bismuth Quadruple Therapy for Eradication ofFrontiers in pharmacology · 2021Article
- Optimizing the MIC breakpoints of amoxicillin and tetracycline for antibiotic selection in the rescue therapy of H. pylori with bismuth quadruple regimen.European journal of clinical pharmacology · 2020Article
- Systematic review: third-line susceptibility-guided treatment for Helicobacter pylori infection.Therapeutic advances in gastroenterology · 2016Review
- Effectiveness of Second through Sixth Line Salvage Helicobacter pylori Treatment: Bismuth Quadruple Therapy is Almost Always a Reasonable Choice.Canadian journal of gastroenterology & hepatology · 2016Article
- Microbiota and probiotics in canine and feline welfare.Anaerobe · 2015Review
- Treatment of Helicobacter pylori infection: Past, present and future.World journal of gastrointestinal pathophysiology · 2014Review
- Treatment of Helicobacter pylori infection: meeting the challenge of antimicrobial resistance.World journal of gastroenterology · 2014Review
- First-line therapy in Helicobacter pylori eradication therapy: experience of a surgical clinic.Ulusal cerrahi dergisi · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHelicobacter pylori eradication therapy with a proton pump inhibitor (PPI), clarithromycin, and amoxicillin fails in >20 % of cases. A rescue therapy with PPI-amoxicillin-levofloxacin still fails in >20 % of patients.
aimTo evaluate the efficacy and tolerability of a bismuth-containing quadruple regimen in patients with two consecutive eradication failures.
methodsProspective multicenter study of patients in whom 1st treatment with PPI-clarithromycin-amoxicillin and 2nd with PPI-amoxicillin-levofloxacin had failed. A 3rd eradication regimen with a 7- to 14-day PPI (standard dose b.i.d.), bismuth subcitrate (120 mg q.i.d. or 240 mg b.i.d.), tetracycline (from 250 mg t.i.d. to 500 mg q.i.d.) and metronidazole (from 250 mg t.i.d. to 500 mg q.i.d.). Eradication was confirmed by (13)C-urea-breath-test 4-8 weeks after therapy. Compliance was determined through questioning and recovery of empty medication envelopes. Adverse effects were evaluated by means of a questionnaire.
resultsTwo hundred patients (mean age 50 years, 55 % females, 20 % peptic ulcer/80 % uninvestigated-functional dyspepsia) were initially included, and two were lost to follow-up. In all, 97 % of patients complied with the protocol. Per-protocol and intention-to-treat eradication rates were 67 % (95 % CI 60-74 %) and 65 % (58-72 %). Adverse effects were reported in 22 % of patients, the most common being nausea (12 %), abdominal pain (11 %), metallic taste (8.5 %), and diarrhea (8 %), none of them severe.
conclusionA bismuth-containing quadruple regimen is an acceptable third-line strategy and a safe alternative after two previous H. pylori eradication failures with standard clarithromycin- and levofloxacin-containing triple therapies.
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