4-DAY QUADRUPLE THERAPY AS A ROUTINE TREATMENT FOR HELICOBACTER-PYLORI INFECTION

Background: H. pylori eradication usually involves treatment with thre e or four drugs for at least 7 days. Possible advantages of short trea tment regimens are better patient compliance and tolerability, and les s adverse effects. Recently two reports have shown a cure rate of > 90 % using a 4-day quadruple therapy. Aim: To confirm these data and to e valuate the efficacy and tolerability of 4-day quadruple therapy in a single centre. Methods: Thirty-eight consecutive patients with nonulce r dyspepsia or peptic ulcer disease, and proven H. pylori infection, r eceived 4 days of quadruple therapy (bismuth, tetracycline, metronidaz ole, lansoprazole). At least 6 weeks after treatment, endoscopy was re peated with six biopsies of antrum and corpus for histology and cultur e. Results: The intention-to-treat cure rate was 34/38 (89.5%, 95% CT: 79.7-99.2%). In the per protocol analysis the cure rate was 34/37 (91 .9%, 95% CI: 83.1-100%). Primary metronidazole resistance was observed in two patients; both were cured. Metronidazole resistance induction was observed in one patient in whom therapy failed. The treatment was generally well tolerated. Conclusion: Routine use of 4-day quadruple a nti-H. pylori treatment is effective and well tolerated.