Modified bismuth quadruple therapy with low-dose metronidazole as first-line therapy for Helicobacter pylori infection

Abstract

Background: Bismuth-containing quadruple therapy is an effective alternative first-line therapy for Helicobacter pylori infection. We evaluated the efficacy and safety of a modified twice-a-day bismuth quadruple regimen (BQT-2) with low-dose (1000?mg total) metronidazole as first-line therapy for the eradication of H?pylori. Materials and Methods: In this prospective pilot study, patients diagnosed with H?pylori infection and naive to eradication therapy were included. The modified BQT-2 therapy consisted of rabeprazole 20?mg, amoxicillin 1?g, metronidazole 500?mg, and tripotassium dicitrato bismuthate 600?mg (elemental bismuth 240?mg) twice daily, given 30?minutes before morning and evening meals for 14?days. H?pylori eradication was assessed by