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A 14-day course of "quadruple therapy" with a proton pump inhibitor, bismuth, tetracycline, and metronidazole or tinidazole is a more complicated but also more effective regimen. In a 2011 randomized, controlled trial, the per protocol eradication rates were 93% with quadruple therapy and 70% with triple therapy.
Bismuth subcitrate potassium is a salt of bismuth (Bi 3+), potassium (K +) and citrate (C 6 H 5 O 7 3−), containing about 25.6% (mass percent) bismuth, which is the active moiety, and 22.9% potassium. Tetracycline is contained as the hydrochloride, and metronidazole as the pure substance. [3]
H pylori is a helical bacterium having a predominantly helical shape, also often described as having a spiral or S shape. [24] [25] Its helical shape is better suited for progressing through the viscous mucosa lining of the stomach, and is maintained by a number of enzymes in the cell wall's peptidoglycan. [1]
Triple therapy may refer to : . a first line therapy in Helicobacter pylori eradication protocols; any of the three drug treatments used in Management of HIV/AIDS; the combination of methotrexate, sulfasalazine, and hydroxychloroquine used to treat rheumatoid arthritis
Clinical trial number NCT03198507 for "ERADICATE Hp2 - Treating Helicobacter Pylori With RHB-105 Compared to Active Comparator (ERADICATE Hp2)" at ClinicalTrials.gov Clinical trial number NCT01980095 for "ERADICATE Hp - Treating Helicobacter Pylori With RHB-105 (ERADICATE Hp)" at ClinicalTrials.gov
From the early 1970s, it has been used in China to treat peptic ulcers, where the mechanism is treatment of the causative Helicobacter pylori infection. [2] In 2002, a journal article suggested its use in treatment of H. pylori infections in children. [3]
An extensive study in Dublin demonstrates that eradicating H. pylori substantially reduces recurrence of ulcers. [49] 1990 Borody's triple therapy became commercialized in the United States under the product name Helidac. [50] Rauws and Tytgat describe cure of duodenal ulcer by eradication of H. pylori using Borody's triple therapy combination ...
However, its effectiveness in eradicating H. pylori has been reducing from 90% to 70%. However, the rate of eradication can be increased by doubling the dosage of pantoprazole or increasing the duration of treatment to 14 days. Quadruple therapy (pantoprazole, clarithromycin, amoxicillin, and metronidazole) can also be used.