Trial reportThe American journal of gastroenterology2016
Rescue Therapy for Helicobacter pylori Eradication: A Randomized Non-Inferiority Trial of Amoxicillin or Tetracycline in Bismuth Quadruple Therapy.
Trial report in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 6 of them syntheses that pooled it.
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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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 6 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- [Evidence-Based Guidelines for the Diagnosis and Treatment ofThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2026Guideline
- Third-line and rescue therapy for refractoryWorld journal of gastroenterology · 2023Pooled it
- Evidence based guidelines for the treatment of Helicobacter pylori infection in Korea 2020.The Korean journal of internal medicine · 2021Guideline
- Evidence-Based Guidelines for the Treatment ofGut and liver · 2021Guideline
- Pooled it
- Guideline
- Minocycline vs. tetracycline in bismuth-containing quadruple therapy for Helicobacter pylori rescue treatment: a multicentre, randomized controlled trial.Journal of gastroenterology · 2023Trial
- Application of a WeChat-based mini-app as a patient reminder in Helicobacter pylori eradication: a prospective multi-center randomized controlled study.BMC gastroenterology · 2022Trial
- 14-Day High-Dose Amoxicillin- and Metronidazole-Containing Triple Therapy With or Without Bismuth as First-Line Helicobacter pylori Treatment.Digestive diseases and sciences · 2020Trial
- Identifying the best regimen for primary eradication of Helicobacter pylori: analysis of 240 cases.MicrobiologyOpen · 2020Trial
- Amoxicillin or tetracycline in bismuth-containing quadruple therapy as first-line treatment forGut microbes · 2020Trial
- Evidence-Based Guidelines for the Diagnosis and Treatment of Helicobacter pylori Infection in Korea: 2025 Revised Edition.The Korean journal of helicobacter and upper gastrointestinal research · 2026Review
- Treatment of Helicobacter pylori Infection in Korea: An Evidence-Based Analysis of the Upcoming 2025 Guideline.The Korean journal of helicobacter and upper gastrointestinal research · 2026Review
- Helicobacter pylori antimicrobial resistance and gene variants in Shandong Province.Scientific reports · 2025Article
- The interval of rescue treatment does not affect the efficacy and safety of Helicobacter pylori eradication: A prospective multicenter observational study.Chinese medical journal · 2025Observational
- Clinical Effectiveness of Penicillin-Free Therapies in First-Line and Rescue Treatments forAntibiotics (Basel, Switzerland) · 2025Review
- Amoxicillin or tetracycline in bismuth-containing quadruple therapy forFrontiers in microbiology · 2025Review
- Efficacy and safety of low-dose tetracycline, amoxicillin quadruple therapy inWorld journal of gastroenterology · 2024Article
- Reply to: Minocycline versus tetracycline in bismuth-containing quadruple therapy for Helicobacter pylori rescue treatment: a multicentre, randomized controlled trial.Journal of gastroenterology · 2024Article
- Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare the efficacy and safety of bismuth-containing quadruple therapy with tetracycline or amoxicillin for rescue treatment of Helicobacter pylori.
methodsThe study was a non-inferiority trial of H. pylori eradication with at least two previous treatment failures. Subjects were randomized to receive 14-day therapy with b.i.d. lansoprazole 30 mg and bismuth 220 mg, plus metronidazole 400 mg q.i.d and amoxicillin 1 g t.i.d (amoxicillin group) or tetracycline 500 mg q.i.d (tetracycline group). Antimicrobial susceptibility was assessed by the agar-dilution method. Primary outcome was H. pylori eradication at 6 weeks after treatment.
resultsIn all, 312 subjects were randomized, 13 were lost to follow-up; 29 violated the protocol. The intention-to-treat, per-protocol, and modified intention-to-treat eradication rates were (amoxicillin) 88.5% (138/156, 95% confidence interval (CI) 83.4-93.5%), 93.7% (133/142, 95% CI 89.7-97.7%), and 92.6% (138/149, 95% CI 88.4-96.8%). With tetracycline, they were 87.2% (136/156, 95% CI 81.9-92.4%), 95.3% (122/128, 95% CI 91.7-99.0%), and 90.7% (136/150, 95% CI 86.0-95.3%). Amoxicillin-, tetracycline-, and metronidazole-resistant rates were 8.3, 1.0, and 87.8%, respectively. Non-inferiority was confirmed (P<0.025). Metronidazole resistance did not affect the efficacy of either therapy. Compliance was greater and moderate and severe adverse events were less among those receiving amoxicillin than those receiving tetracycline.
conclusionsThe novel bismuth-containing quadruple therapy with metronidazole and amoxicillin is an alternative to classical bismuth quadruple therapy for H. pylori rescue treatment as it provides similar eradication with superior safety and compliance.
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