Trial reportPloS one2018
Efficacy and Tolerability of Two Quadruple Regimens: Bismuth, Omeprazole, Metronidazole with Amoxicillin or Tetracycline as First-Line Treatment for Eradication of Helicobacter Pylori in Patients with Duodenal Ulcer: A Randomized Clinical Trial.
Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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.
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
12 citing papers in PubMed, 41 citations in OpenAlex.
- The Efficacy of Two Triple Therapy Regimens and One Quadruple Regimen [Omeprazole, Amoxicillin, Metronidazole with Bismuth] in EradicatingReviews on recent clinical trials · 2025Trial
- Amoxicillin or tetracycline in bismuth-containing quadruple therapy as first-line treatment forGut microbes · 2020Trial
- 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
- Update on the Management of Helicobacter pylori Infection in Children and Adolescents.Current gastroenterology reports · 2025Review
- Optimizing the Routine Use of Clinical Guidelines by Addition of Supplements (Probiotics and/or Bismuth) toAntibiotics (Basel, Switzerland) · 2025Article
- Efficacy and Safety of Modified Bismuth Quadruple Therapy for First-LineMicroorganisms · 2025Review
- Amoxicillin or tetracycline in bismuth-containing quadruple therapy forFrontiers in microbiology · 2025Review
- An Update on Eradication ofMiddle East journal of digestive diseases · 2024Review
- A Comparison of Doxycycline and Amoxicillin Containing Quadruple Eradication Therapy for TreatingPathogens (Basel, Switzerland) · 2022Article
- The Efficacy, Safety, and Tolerability of Levofloxacin Quadruple Therapy forEvidence-based complementary and alternative medicine : eCAM · 2022Article
- Antibiotic Resistance of Helicobacter pylori Isolated from Patients after Partial Gastrectomy: A Retrospective Study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2021Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo evaluate the efficacy and tolerability of tetracycline vs. high-dose amoxicillin in bismuth-based quadruple therapy for Helicobacter pylori(H. pylori) eradication.
methodsThis randomized, open-label clinical trial included 228 patients with H.pylori infection and duodenal ulcer without a history of H.pylori treatment. Patients were randomly divided into two groups. The amoxicillin group received metronidazole 500mg, bismuth subcitrate 240mg, and amoxicillin 1000mg, all three times a day, plus omeprazole 20 mg twice a day, for 14 days. The tetracycline group received metronidazole 500mg three times a day; bismuth subcitrate240mg and tetracycline HCl 500mg, both four times a day; and omeprazole 20 mg twice a day, for 14 days. Evaluation for compliance and drug-relatedadverse effects were evaluated at the end of two weeks. Eight weeks after the end of treatment, the rate of H.pylori eradication was assessed by the C13urease breath test.
resultsThere were no significant demographic differences between the two groups. Eradication rate was higher with the amoxicillin-containing regimen than the tetracycline-containing regimen: 105/110 (95.51%; 95% confidence interval, 91.5%-99.3%) vs. 88/105 (83.8%; 95%CI, 76.7%-90.8%) by per-protocol analysis (p = 0.005) and 92.9% (95%CI, 88.1%-97.6%) vs. 76.5% (95%CI, 68.7%-84.2%) by intention-to-treat analysis (ITT, p = 0.001). Adverse effects were significant higher in the tetracycline groupthan in the amoxicillin group (65.2% vs. 43.4%; p = 0.001).
conclusionBismuth-based quadruple therapy including high-dose amoxicillin and metronidazole achieved an acceptable rate of H.pylori infection eradication with good tolerance in patients with duodenal ulcer. This regimen can overcome treatment resistance in areas with high prevalence of metronidazole and clarithromycin resistance.
trial registrationThe Thai Clinical Trial Registry (TCTR) 20170623004.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.