First-line Therapy for H. pylori Infection in China

As antibiotic resistance rates increase, the success of standard therapy for Helicobacter pylori infection is decreasing. Both sequential and bismuth-based quadruple therapies have been recommended as first-line therapy in areas with high clarithromycin resistance.

Investigators in Hong Kong randomized 357 treatment-naive patients with H. pylori infection to receive either sequential therapy or a modified bismuth-based quadruple therapy for 10 days. The sequential therapy regimen comprised esomeprazole (20 mg twice daily) for 10 days and amoxicillin (1 g twice daily) for the first 5 days, followed by clarithromycin (500 mg twice daily) and metronidazole (400 mg four times daily) for the next 5 days. The quadruple therapy regimen comprised es…