From the Guidelines
The recommended quadruple therapy regimen for H. pylori treatment does not include Buscopan (hyoscine), but rather a combination of a proton pump inhibitor (PPI), bismuth, tetracycline, and metronidazole, as outlined in the 2019 Gastroenterology study 1. The most effective quadruple therapy regimen for H. pylori treatment is the Bismuth quadruple therapy, which consists of:
- A proton pump inhibitor (PPI) such as omeprazole 20mg twice daily
- Bismuth subsalicylate 525mg four times daily
- Tetracycline 500mg four times daily
- Metronidazole 500mg three to four times daily This regimen is recommended for 10-14 days, with a preferred duration of 14 days, as stated in the study 1. The Bismuth quadruple therapy is particularly useful in areas with high clarithromycin resistance or for patients who have failed previous clarithromycin-based therapies. Key points to note:
- The bismuth component helps protect the gastric mucosa and has direct antimicrobial effects against H. pylori.
- Tetracycline and metronidazole work synergistically to disrupt bacterial protein synthesis and DNA, respectively.
- The PPI raises gastric pH, enhancing antibiotic efficacy and providing symptom relief.
- Patients should take the medications with meals and avoid alcohol during treatment due to potential disulfiram-like reactions with metronidazole.
- If tetracycline is unavailable, doxycycline 100mg twice daily can be substituted.
- Compliance is crucial for eradication success, and confirmation of H. pylori elimination should be performed at least 4 weeks after therapy completion, as recommended by the study 1.
From the Research
Buscopan (Hyoscine) Quad Therapy for H pylori Treatment
There is no direct evidence of a recommended quadruple therapy regimen for H pylori treatment that includes Buscopan (hyoscine). However, several studies have investigated the effectiveness of different quadruple therapy regimens for H pylori eradication.
Quadruple Therapy Regimens
- A study published in 1998 2 evaluated a new quadruple therapy regimen consisting of omeprazole, metronidazole, clarithromycin, and amoxicillin for 5 days, which showed an eradication rate of 96% in patients without previous dual therapy and 92% in patients with previous dual therapy.
- Another study published in 2013 3 investigated a 10-day quadruple regimen with esomeprazole, metronidazole, amoxicillin, and clarithromycin, which achieved an eradication rate of 91.5% in first-line treatment and 60.6% in second-line treatment.
- A study published in 2004 4 tested a twice-daily quadruple therapy regimen with metronidazole, tetracycline, bismuth, and rabeprazole for 14 days, which showed an eradication rate of 92.3%.
- A pilot study published in 2000 5 evaluated a 4-day quadruple therapy regimen with amoxicillin, clarithromycin, tinidazole, and omeprazole, which achieved an eradication rate of 87.5% by intention-to-treat and 90.7% by per protocol.
Conclusion Not Provided
As per the instructions, no conclusion will be provided. The information above summarizes the available evidence on quadruple therapy regimens for H pylori treatment, but it does not include Buscopan (hyoscine) as part of the regimens.
No Direct Evidence for Buscopan Quad Therapy
There are no research papers that directly investigate the use of Buscopan (hyoscine) in a quadruple therapy regimen for H pylori treatment, as mentioned in the study by 6, which discusses the use of bismuth-based quadruple therapy as a first-line regimen in areas with high rates of clarithromycin and metronidazole resistance.