The Efficacy of Quadruple Therapy Versus Triple Therapy in Helicobacter pylori Eradication

Background and aims <i>Helicobacter pylori</i> (<i>H. pylori</i>) is a significant cause of various gastrointestinal diseases, including gastritis, peptic ulcers, and even stomach cancer. Therefore, eradication is essential to prevent these conditions and their associated complications. The emergence of antibiotic-resistant strains and the lack of sufficient data on antibiotic sensitivity have made it increasingly challenging to treat <i>H. pylori</i>, which has led to the emergence of various regimens. This article will compare the efficacy of different regimens to provide insights into the most effective treatment options for <i>H. pylori</i>. Methods Our study is a retrospective, single-center study that reviews the data of 1,246 outpatients who were diagnosed with <i>H. pylori</i> infection and underwent testing to confirm eradication of <i>H. pylori</i> after receiving the therapeutic regimen. Patients received one of the following regimens: clarithromycin-based triple therapy (CT), levofloxacin-based triple therapy (LT), or bismuth-based quadruple therapy (BT). Results In total, 1,246 individuals were treated with different regimens, resulting in an overall success rate of 69.3%. The success rates of the triple and quadruple therapies were comparable, with 67.7% and 74.3%, respectively. When looking at individual treatment regimens, BT had the highest success rate at 74.3%, followed by CT with 67.9% and LT with 64.8%. Conclusion In Bahrain, BT demonstrates greater effectiveness compared to commonly used triple therapies. Despite this, the overall eradication rate remains low, indicating a significant presence of resistance within the population. Therefore, it is crucial to emphasize the need for sensitivity testing to develop local antibiograms and ensure cost-effectiveness.