title: First-line Bismuth-containing Five-day Concomitant Quintuple Therapy for Helicobacter Pylori Eradication.
abstract: BACKGROUND
  Widespread use of antibiotics has resulted in increased rates of antibiotic resistance and decreased rates of Helicobacter pylori (H. pylori) eradication, leading to a search for newer therapeutic options. This study aimed to examine the efficacy, tolerability, and patient compliance of a first-line bismuth-containing 5-day concomitant quintuple therapy.
  
  
  METHODS
  This prospective study included 144 eradication treatment naïve H. pylori positive patients with dyspeptic complaints. Patients received the following concomitant quintuple therapy for 5 days: bismuth subcitrate 300 mg q.i.d, omeprazole 20 mg b.i.d, clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d., and metronidazole 500 mg t.i.d. Eradication was assessed with H. pylori stool antigen test or urea-breath test 6 weeks after the completion of therapy.
  
  
  RESULTS
  Treatment compliance rate in this study was 97.2%. Intention to treat and per-protocol eradication rates were 134/144 (93.1%, 95% CI, 88.9-97.2) and 134/140 (95.7%, 95% CI, 92.2-98.6), respectively. Side effect was reported by 8.5% of the patients that attended follow-up visits, including epigastric pain (2.8%), nausea/vomiting (2.1%), diarrhea (1.4%), taste disturbance (1.4%), and fatigue (0.7%).
  
  
  CONCLUSIONS
  Bismuth-containing, short course, quintuple concomitant therapy appears to be an effective and safe therapeutic option for the first-line H. pylori eradication, particularly in populations with high resistance.
authors.affiliation: Department of Gastroenterology, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Dolapcioglu
authors.affiliation: Department of Family Medicine, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sayiner
authors.affiliation: Department of Family Medicine, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Esra Elif
authors.initials: EE
authors.lastname: Akkus
authors.affiliation: Department of Gastroenterology, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Kural
authors.affiliation: Department of Pathology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Dolapcioglu
authors.affiliation: Department of Family Medicine, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Resat
authors.initials: R
authors.lastname: Dabak
authors.affiliation: Department of Gastroenterology, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Ahishali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001729:Bismuth / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000379:methods; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013995:Time; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001729:Bismuth
keywords: Helicobacter pylori; bismuth citrate; concomitant therapy; eradication; first-line treatment