Limited effectiveness with a 10‐day bismuth‐containing quadruple therapy (Pylera^®) in third‐line recue treatment for Helicobacter pylori infection. A real‐life multicenter study

Abstract

In an area of high antibiotic resistance to H. pylori, 10-day Pylera plus double-dose PPI emerged as an alternative as third-line therapy, although not achieving optimal eradication rates. TRAEs were common but were neither severe nor did they condition compliance.

The “three‐in‐one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice

“…Patient's compliance is an issue in the treatment of H. pylori infection because of the complexity of the antimicrobial regimens. In our study, a poor compliance negatively affected the outcome of the three‐in‐one BQT, as also reported by previous reports . However, almost all patients treated with the three‐in‐one BQT had a good compliance.…”

“…These results are consistent with previous studies in clinical practice, in Italy, Germany, and Spain, which used the same pharmacological formulation of BQT, but in smaller samples of patients. However, some studies reported a slightly lower eradication rate in third‐line treatment. Fiorini et al.…”

“…Fiorini et al. reported eradication rates of 79.3% and 82.1%, and a Spanish study showed eradication rates of 80.2% and 84.4% at ITT and PP analyses, respectively . The small variability in the eradication rate may be due to the small sample of patients included in the third‐line studies, but also to the different prevalence of metronidazole‐resistant strains, which depends on the geographic area and the use of previous metronidazole‐containing treatments.…”

“…As the three‐in‐one BQT has just recently become available on the market, data on the efficacy and tolerability of this new formulation of BQT in a large series of patients in daily clinical practice are still scarce. Few studies have been published so far, and all, but one, included relatively small series of patients (ranging from 100 to 200). In addition, no data on the role of probiotics supplementation on the therapeutic performance of three‐in‐one BQT are available.…”

Treatment of Helicobacter pylori infection in 2018

“…Sequential therapy remains in use in areas of high resistance, but may prove challenging in terms of compliance, and is no longer recommended . Three‐in‐one formulations of bismuth quadruple therapy (BQT) may improve compliance . Probiotics appear to have some effect on H. pylori eradication, as their addition likely improves compliance by reducing the side effects of antibiotics .…”