Evidence map›Paper›PMID 41291495›Full record

Trial reportBMC gastroenterology2025

Bismuth-Based quintuple therapy: a step beyond quadruple regimens in H. Pylori treatment and the impact of patient compliance.

R Dertli, M Asıl, Y Atayan, U Coşar, R Yolaçan, M Bıyık, M Keskin

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. A Critical Perspective on Helicobacter pylori Treatment Strategies: Are Levofloxacin-Based Regimens Truly Suitable as First-Line Therapy?The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

R DertliSchool of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Konya, Turkey. dededoc@hotmail.com.
M AsılSchool of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Konya, Turkey.
Y AtayanSchool of Medicine, Department of Internal Medicine, Division of Gastroenterology, İnönü University, Malatya, Turkey.
U CoşarSchool of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Konya, Turkey.
R YolaçanGaziantep City Hospital, Gastroenterology Clinic, Gaziantep, Turkey.
M BıyıkSchool of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Konya, Turkey.
M KeskinSchool of Medicine, Department of Internal Medicine, Division of Gastroenterology, Necmettin Erbakan University, Konya, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHelicobacter pylori (H. pylori) infection is one of the most common infections affecting humanity. As the level of development and socio-economic status of countries decreases, the prevalence of H. pylori infection increases. Although numerous H. pylori eradication regimens have been tested in recent years, the desired level of eradication success has not been achieved. In this study, we aimed to evaluate the effectiveness of alternative treatment protocols.

methodsPatients who presented to our clinic between 2023 and 2024 were included in the study. The patient groups were treated with Rabeprazole (R), Metronidazole (M), Amoxicillin (A), and Bismuth (B) (RMAB), or with Esomeprazole (E), Metronidazole (M), Tetracycline (T), and Bismuth (B) (EMTB) regimens. Patients who were resistant to both RMAB and EMTB treatment protocols received quintuple therapy with RTAMB and ETAMB. All patients were thoroughly informed about their treatment process, management of side effects, and adherence to the therapy.

resultsA total of 611 patients who received H. pylori treatment were included in the study. Of the participants, 60.7% were women, and the mean age was 53.7 ± 15.2 years. For post-treatment response evaluation, 73.5% (n = 449) of the patients returned to our clinic. The overall H. pylori eradication success rate for the entire patient group was 49.6%. The success rates for patients receiving RMAB and EMTB treatments were 48.2% and 51.3%, respectively. Among the group of patients who were under controlled supervision and had optimal treatment compliance (n = 449), the success rates for the RMAB and EMTB treatments were found to be 66.9% and 68.5%, respectively. A total of 105 patients who were resistant to the RMAB and EMTB treatments were given RTAMB and ETAMB therapy. Of these patients, 96.2% complied with the treatment and underwent a response evaluation. The eradication success rates for patients treated with the RTAMB and ETAMB protocols were 65.6% and 67.6%, respectively.

conclusionIn this study, we demonstrated that bismuth-based quintuple therapy can be used as an alternative to bismuth-based quadruple therapies and other high-risk treatments. However, we also highlighted the critical importance of treatment adherence.

Indexed as

AntacidsAnti-Bacterial AgentsBismuthHelicobacter InfectionsProton Pump InhibitorsAdultAgedDrug Resistance, BacterialDrug Therapy, CombinationFemaleHelicobacter pyloriHumansMaleMedication AdherenceMiddle AgedTreatment OutcomeAntacidsAnti-Bacterial AgentsBismuthProton Pump InhibitorsBismuthEsomeprazoleHelicobacter pyloriQuadruple therapiQuintuple therapyRabeprazole

Identifiers

PMID41291495
PMCPMC12649043

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.