Dr. Francis Megraud from CHU Pellegrin in Bordeaux, France, who coauthored an accompanying editorial, told Reuters Health by email, “Bismuth-based quadruple therapy has the advantage to avoid either clarithromycin testing in a tailored treatment or of taking clarithromycin for nothing in an empiric treatment, given that clarithromycin is not included in the formula. However, the use of this bismuth quadruple therapy depends on its availability and cost.”
“An important consequence of treatments, not yet explored, the impact on digestive microbiota, may change our views,” Dr. Megraud added.
Dr. Murat Kekilli from Ankara Education and Research Hospital in Turkey recently reported on the inefficacy of triple therapy in the first-line treatment of H. pylori infection. In an email to Reuters Health, Dr. Kekilli, who was not involved in the new work, maintained that “bismuth quadruple therapy should be the treatment of choice regardless of clarithromycin resistance prevalence.”
The trial did not have commercial funding.
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