ReviewExpert review of anti-infective therapy2018
Understanding treatment guidelines with bismuth and non-bismuth quadruple Helicobacter pylori eradication therapies.
Review in Expert review of anti-infective therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07146594 (Clinical Evaluation of a 14day Modified Bismuth Quadruple Therapy for the Eradication of H. Pylori in a High Clarithromycin and Metronidazole Resistance Area), which is not on this map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Clinical Evaluation of a 14day Modified Bismuth Quadruple Therapy for the Eradication of H. Pylori in a High Clarithromycin and Metronidazole Resistance Area
Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Guideline-based bismuth quadruple therapy for helicobacter pylori infection in China: A systematic review and network meta-analysis.PloS one · 2025Pooled it
- Network meta-analysis of treatment interventions forFrontiers in pharmacology · 2024Pooled it
- Bismuth-Based quintuple therapy: a step beyond quadruple regimens in H. Pylori treatment and the impact of patient compliance.BMC gastroenterology · 2025Trial
- Management of Helicobacter pylori treatment failures: A large population-based study (HP treatment failures trial).PloS one · 2023Trial
- Efficacy and safety of triple therapy containing berberine hydrochloride, amoxicillin, and rabeprazole in the eradication of Helicobacter pylori.Journal of digestive diseases · 2022Trial
- Ten-Day Concomitant, 10-Day Sequential, and 7-Day Triple Therapy as First-Line Treatment forGut and liver · 2019Trial
- Review
- Review Article: Classic Bismuth Quadruple Therapy for Helicobacter pylori Infection-Questions Focused on Clinical Practice.Alimentary pharmacology & therapeutics · 2026Review
- Antimicrobial Resistance Patterns and Determinants ofAntibiotics (Basel, Switzerland) · 2025Article
- [Establishment and optimization of a routinely resistance testing of Helicobacter pylori to encourage a resistance-guided therapy].Zeitschrift fur Gastroenterologie · 2025Article
- In Vitro Susceptibility and Synergistic Effect of Bismuth AgainstAntibiotics (Basel, Switzerland) · 2024Article
- Antibiotic Susceptibility-Guided Concomitant Therapy Regimen with Vonoprazan, High-Dose Amoxicillin, Clarithromycin, and Metronidazole forMicroorganisms · 2024Article
- Success ofJournal of the Canadian Association of Gastroenterology · 2024Article
- Best Practices forGastroenterology & hepatology · 2024Article
- Review
- Clarithromycin sustained-release tablet may be an improper therapy for the eradication ofTherapeutic advances in gastroenterology · 2024Article
- 6-gingerol and its derivatives inhibitFrontiers in microbiology · 2024Article
- Antibiotic Resistance, Susceptibility Testing and Stewardship inInternational journal of molecular sciences · 2023Review
- Treatment ofAntibiotics (Basel, Switzerland) · 2023Review
- Evolution ofAntibiotics (Basel, Switzerland) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
introductionRecent Helicobacter pylori treatment guidelines recommend the 4-drug combinations bismuth quadruple therapy and concomitant therapy. Areas covered: We review antimicrobial therapy for H. pylori in the context of antimicrobial therapy in general and specifically in relation to good antimicrobial stewardship (defined as optimal selection, dose, and duration of an antimicrobial that results in the best clinical outcome for the treatment of infection, with minimal toxicity to the patient and minimal impact on subsequent resistance). Expert commentary: The lack of regional and local H. pylori susceptibility data prevents implementation of susceptibility-based antimicrobial therapy and forces compromises. Bismuth quadruple therapy employing at least 1,500 mg of metronidazole for 14 days is effective despite metronidazole resistance. The main drawback is side effects causing reduced adherence. Versions where amoxicillin replaces metronidazole or tetracycline also appear effective. It is likely that bismuth quadruple therapy can be simplified by giving bismuth and possibly tetracycline b.i.d., possibly with fewer side effects. Concomitant therapy (a proton pump inhibitor, metronidazole, clarithromycin, amoxicillin) is ineffective with dual clarithromycin-metronidazole resistance and all patients receive at least one unnecessary antibiotic thus promoting antimicrobial resistance worldwide. Concomitant therapy should be abandoned when susceptibility testing becomes widespread or an alternate becomes available.
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What OpenQuestion holds
Registered trials
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.