Why is bismuth used for quadruple therapy?
Why is bismuth used for quadruple therapy?
Bismuth-based quadruple therapy is recommended by a recent review to be the first-line treatment for H. pylori eradication, replacing clarithromycin-based triple therapy. It is because the eradication rates of triple therapy in adults have declined due to increasing clarithromycin resistance.
What is quadruple therapy for PUD?
This is the traditional quadruple regimen and includes a bismuth salt (subsalicylate 525 mg or subcitrate potassium 420 mg), metronidazole 250 mg, and tetracycline 375 to 500 mg, all taken four times daily, in addition to a PPI taken twice per day.
What is the purpose of bismuth in H. pylori treatment?
Bismuth exerts direct bactericidal effect on Helicobacter pylori by different ways: forms complexes in the bacterial wall and periplasmic space, inhibits different enzymes, ATP synthesis, and adherence of the bacteria to the gastric mucosa.
What is bismuth based therapy?
Bismuth triple therapy (bismuth compound, metronidazole and tetracycline) is the oldest effective regimen to cure Helicobacter pylori infection. When tetracycline is replaced by amoxycillin the cure rate decreases. In 1990, it was the first-line regimen.
How do you take bismuth quadruple therapy?
- Adults—One dose (two 262.4 milligrams [mg] of bismuth subsalicylate, one 250 mg of metronidazole, and one 500 mg of tetracycline) 4 times a day, taken with meals and at bedtime, for 14 days.
- Children—Use and dose must be determined by your doctor.
How effective is bismuth quadruple therapy for H. pylori?
pylori (susceptible to amoxicillin and tetracycline) and reported that among 101 patient with metronidazole resistant strains 14 day bismuth quadruple therapy cured 93.1% per protocol, which was similar to the effectiveness of bismuth quadruple therapy where amoxicillin was substituted for metronidazole (i.e., 94.6% of …
When is quadruple therapy used?
Nonbismuth quadruple therapy (i.e., concomitant) for 10 to 14 days (the Toronto Consensus strongly recommends 14 days) is another first-line regimen. This regimen may also be used as salvage therapy in patients with persistent H pylori infection when the primary or preferred therapy fails.
How effective is quadruple therapy for H. pylori?
A 7-d quadruple therapy consisting of rabeprazole (20 mg bid) amoxicillin (1.0 g, bid) levofloxacin (0.2 g, bid) and furazolidone (0.1 g, bid), has high efficacy in the treatment of H. pylori infection with an eradication rate of 86% by intention-to-treat analysis and 94% by per-protocol analysis.
What is non bismuth quadruple therapy?
Non-bismuth containing quadruple therapy (concomitant therapy) is an alternative treatment for Helicobacter pylori (H. pylori) eradication with increasing clarithromycin-resistant strains over times.
What causes H pylori infection?
You can get H. pylori from food, water, or utensils. It’s more common in countries or communities that lack clean water or good sewage systems. You can also pick up the bacteria through contact with the saliva or other body fluids of infected people.
When do you use quadruple therapy for H. pylori?
