Korean J Gastrointest Endosc.  2009 Sep;39(3):131-135.

Eradication Rates of Bismuth-based Quadruple Therapy as a Second-line Treatment for Helicobacter pylori Infection

  • 1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. kimtaeho@catholic.ac.kr


There has been a substantial decline in Helicobacter pylori (H. pylori) cure rates with standard triple therapy in recent years. Therefore, great emphasis has been placed on second line treatment for its successful eradication. The aim of this study was to evaluate the efficacy of bismuth based quadruple therapy as a second line treatment for H. pylori infection.
From January 2001 to December 2007, the hospital records of 215 patients who failed to the standard triple therapy were reviewed retrospectively. The patients were treated with bismuth based quadruple therapy (PPI, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid). The successful eradication of H. pylori was defined as negative result from histology, CLO test or (13)C-urea breath test.
Eradication rates by intention-to-treat (ITT) and per-protocol (PP) analyses with quadruple therapy were 64% (137/215) and, 91% (137/151) respectively. The eradication rates were not significantly different according to diseases, duration of treatment, area and proton pump inhibitors. The PP eradication rates for the years from 2001 to 2007 were not significantly different.
The bismuth based quadruple therapy is still effective as the second line treatment for the eradication of H. pylori.


Helicobacer pylori; Eradication rate; Second line; Quadruple
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