- Concomitant (QuadC) and bismuth (QuadB) quadruple therapies achieved over 90% H. pylori eradication—significantly outperforming standard triple therapy (74%).
- Sequential quadruple therapy (QuadS) yielded 84% eradication with fewer adverse events and may be suitable when bismuth is unavailable.
- Quadruple regimens had more adverse events (17%–18%) than triple therapy (6%), but adherence remained excellent (97%) across groups.
- Prior eradication attempts, poor adherence, and absence of statin use independently predicted treatment failure.
- In high-prevalence regions, empiric use of concomitant or bismuth quadruple therapy should be the default, with close attention to adherence and management after prior failures.
Source: UEG Week 2025
Do quadruple therapies beat triple for H. pylori?
Conexiant
October 14, 2025
