Efficacy of asmeprazole combined with amoxicillin versus bismuth-containing quadruple therapy in initially treated patients with Helicobacter pylori infection

Objective To compare the curative efficacy between esomeprazole combined with amoxicillin and bismuth-containing quadruple therapy in patients with Helicobacter pylori infection.

Methods A total of 240 newly treated patients with Hp infection were randomly divided into dual therapy group(orally taken 20 mg of esomeprazole and 750 mg of amoxicillin)and quadruple therapy group(orally taken esomeprazole 20 mg, colloidal bismuth 250 mg, amoxicillin 1.0 g and clarithromycin 0.5 g, twice a day, the course of treatment was 14 d). The incidence of adverse reactions in the two groups was followed up on the 3rd, 7th and 14th day of treatment, and the medication compliance of the two groups was compared. Liver function was reexamined one month after the end of eradication treatment, and ¹⁴C urea breath test was reexamined within 1 month to 2 months after with drawal to evaluate efficacy (Hp eradication rate).

Results There were no significant differences in the eradication rate of intention-to-treat analysis (ITT) results (66.67%, 72.50%), modified intention-to-treat analysis (MITT) results (82.47%, 86.14%) and per-protocol analysis (PP) results (81.91%, 86.60%) between the two groups (P > 0.05). There were no significant differences in the incidence of adverse reactions, incidence of liver function damage and compliance of drugs administration (P > 0.05). The adverse reactions of the two groups disappeared after drug withdrawal, no serious adverse reactions occurred.

Conclusion Esomeprazole combined with amoxicillin is as effective as bismuth-containing quadruple therapy, and has good safety andcompliance of drugs administration.