Loading...
Eradication rates of Helicobacter pylori with standard therapy are decreasing as antibiotic resistance increases in many countries. Bismuth-based therapies have shown some promise (NEJM JW Gastroenterol Jul 8 2013), but nonbismuth therapies remain common. Now, researchers have compared the efficacy of two nonbismuth, quadruple regimens — one concomitant and one partly sequential — in areas of Spain and Italy with similarly high rates of clarithromycin resistance (approximately 20%).
In a multicenter, noninferiority trial, investigators randomized 343 treatment-naive patients with H. pylori infection to receive 40 mg of omeprazole, 1 g of amoxicillin, 500 mg of clarithromycin, and 500 mg of nitroimidazole twice daily for 14 days (concomitant …