Zinc carnosine-based modified bismuth quadruple therapy vs standard triple therapy for Helicobacter pylori eradication: A randomized controlled study

doi:10.12998/wjcc.v10.i1.227

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World Journal of Clinical Cases

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Randomized Controlled Trial

World J Clin Cases. Jan 7, 2022; 10(1): 227-235
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.227

Zinc carnosine-based modified bismuth quadruple therapy vs standard triple therapy for Helicobacter pylori eradication: A randomized controlled study

Nour Ibrahim, Hassan El Said, Ali Choukair

Nour Ibrahim, Faculty of Medical Sciences, Lebanese University, Beirut 0000, Lebanon

Hassan El Said, Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Beirut 0000, Lebanon

Ali Choukair, Department of Gastroenterology, Clemenceau Medical Center, Dubai 00000, United Arab Emirates

Author contributions: Choukair A designed the study, collected the data and wrote the first draft of the manuscript; Ibrahim N analyzed the data and contributed to the manuscript writing; all authors critically revised the manuscript and read and approved the final version of the manuscript.

Supported by

Synergy Group

Institutional review board statement: This study was reviewed and approved by the Clinical Research Ethics Committee of NMC specialty hospital.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Data sharing statement: No additional data are available.

Corresponding author: Nour Ibrahim, MD, Research Fellow, Faculty of Medical Sciences, Lebanese University, Old Saida Road Street, Hadath Area, Beirut 0000, Lebanon.nouribrahim5@hotmail.com

Received: June 25, 2021
Peer-review started: June 25, 2021
First decision: July 27, 2021
Revised: August 7, 2021
Accepted: November 28, 2021
Article in press: November 28, 2021
Published online: January 7, 2022
Processing time: 187 Days and 14.9 Hours

ARTICLE HIGHLIGHTS

Research background

The rate of resistance of Helicobacter pylori (H. pylori) infection has been increasing worldwide. It is necessary to consider new alternatives to overcome the failure of H. pylori eradication rate.

Research motivation

There is shortage in reports on whether zinc carnosine is effective against H. pylori eradication.

Research objectives

Investigate the effect of triple therapy (TT) vs modified bismuth quadruple therapy against H. pylori eradication rate.

Research methods

Ninety-two patients with dyspepsia symptoms and positive ¹³C-urea breath test were randomly assigned in to the following two groups: TT group treated for 14 d using esomeprazole (40 mg twice daily), amoxicillin (1 g twice daily) and clarithromycin (500 mg twice daily). On the other hand, the modified bismuth quadruple therapy fortified with zinc carnosine was prescribed a 10-d of TT in addition to bismuth subcitrate (240 mg twice daily) and zinc carnosine (75 mg twice daily). A ¹³C-urea breath test was repeated after 4 wk from the completion of the eradication therapy.

Research results

The eradication rate was higher in the modified bismuth quadruple therapy group compared to that of the standard TT group (P = 0.003).

Research conclusions

Ten-day modified bismuth quadruple therapy is a safe and effective regimen for eradicating H. pylori infection.

Research perspectives

The first-line therapy for H. pylori eradication should be re-evaluated. Alternative regimens with higher eradication of H. pylori should be further investigated.