title: Different bismuth-based therapies for eradicating Helicobacter pylori: Randomized clinical trial of efficacy and safety.
abstract: OBJECTIVE
  Bismuth salts are used for treating dyspepsia, and they exert antibacterial effects on Helicobacter pylori. This study aimed to compare the efficacy and safety of three bismuth-containing combination regimens for H. pylori eradication in a Turkish population.
  
  
  METHODS
  In this single-center study, 149 patients, who were diagnosed with H. pylori infection with urea breath test and histopathological examination, were randomized to receive the following therapies for 14 days: (1) bismuth-containing clarithromycin-based triple therapy (CBS-LAC), (2) bismuth-containing levofloxacin-based triple therapy (CBS-LAL), and (3) bismuth-containing quadruple therapy (BCQT). Eradication rates were evaluated six weeks after the treatment by performing intention to treat (ITT) and per protocol (PP) analyses. In addition, data on side effect profiles and patient compliance were collected.
  
  
  RESULTS
  PP and ITT analyses showed that eradication rates were 86% and 81.1%, respectively, with BCQT; 68.3% and 66.7%, respectively, with CBS-LAL therapy; and 65.3% and 59.3%, respectively, with CBS-LAC therapy. Eradication rates obtained using PP and ITT analyses were statistically significant for all the regimens.
  
  
  CONCLUSIONS
  Addition of bismuth to standard triple and levofloxacin-based regimen did not show an acceptable increase in eradication rates. Therefore, BCQT may be preferred for the first-line treatment of H. pylori infection.
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Gastroenterology, Demetevler/Ankara, Turkey. Electronic address: halesumer@yahoo.com.
authors.forename: Hale
authors.initials: H
authors.lastname: Gokcan
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Gastroenterology, Demetevler/Ankara, Turkey.
authors.forename: Erkin
authors.initials: E
authors.lastname: Oztas
authors.affiliation: Ankara Oncology Education and Research Hospital, Department of Gastroenterology, Demetevler/Ankara, Turkey.
authors.forename: Ibrahim Koral
authors.initials: IK
authors.lastname: Onal
mesh_terms: D000328:Adult; D001729:Bismuth / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D001729:Bismuth