Fourteen-Day Amoxicillin- or Tetracycline-Containing Bismuth Quadruple Therapy versus 14-Day Metronidazole-Based Triple Therapy as the Treatment for Clarithromycin-Resistant Helicobacter pylori Infection: A Multicenter Randomized Controlled Trial.
Gut LiverSep 15, 2026
Myeongseok Koh, Cheol Woong Choi, Dae Gon Ryu et al.
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In 30 seconds
This multicenter randomized controlled trial evaluated the efficacy of bismuth-containing quadruple therapy (PAM-B) versus standard PAM and PBMT for treating clarithromycin-resistant Helicobacter pylori infections in South Korea. The study found that PAM-B achieved a significantly higher eradication rate of 84.8% compared to 68.2% for PAM (p=0.024), with comparable rates to PBMT.
Key findings
- Eradication rate for PAM-B was 84.8%, significantly higher than PAM's 68.2% (p=0.024).
- In per-protocol analysis, PAM-B had a 96.5% eradication rate compared to PAM's 75.4% (p=0.001).
- Nausea and vomiting occurred less frequently in the PAM-B group (6.8%) than in the PBMT group (25.0%; p=0.007).
- Severe adverse events were rare and resolved after treatment discontinuation.
Why it matters
The increasing resistance of Helicobacter pylori to clarithromycin necessitates effective treatment alternatives. This study suggests that PAM-B may be a viable first-line option, potentially improving eradication rates and patient tolerability.