- 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.
Do quadruple therapies beat triple for H. pylori?
Conexiant
October 14, 2025
