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Thai Journal of Gastroenterology

Thai Journal of Gastroenterology

2008 Vol.9 No.2

Article :
Non-antibiotic Quadruple Regimen for Helicobacter pylori Eradication

Author :
Praditthongngam C
Pisespongsa P
Praisontarangkul O
Chitapanarux T
Leerapun A
Thongsawat S

Abstract :




Antimicrobial resistance and patient compliance are important factors leading to H. pylori eradication failure. To avoid such problems, we formulated a new PPI-based non-antibiotic regimen to eradicate H. pylori. This concoction comprises of curcumin, probiotics, bismuth subsalicylate and esomeprazole. Curcumin is one of natural substances widely investigated as a potential alternative for treatment of H. pylori infection, as it can inhibit adhesion of H. pylori to stomach. Bismuth compounds can inhibit growth of H. pylori;while probiotics can decrease colonization of this organism.


To determine the efficacy of a PPI-based non-antibiotic quadruple regimen in H. pylori eradication.



Sixteen NUD patients (11 females, mean age 43.5 12.5 years, range 22-63) tested positiveH. pylori were enrolled. Patients were administered for 7 days of curcumin 48 mg q.i.d., Lyophilized live Lactobacillus acidophilus + Bifidobacterium infantis 2 capsules b.i.d., bismuth subsalicylate 524 mg q.i.d., and esomeprazole 20 mg b.i.d. All patients were evaluated by 14C-urea breath test and gastrointestinal symptom score. Primary and secondary end point was eradication rate and gastrointestinal symptom improvement, respectively.


One of 16 patients (6.25%) was cured of H. pylori infection. A significant improvement in overall GI symptom (T0 : median 6, range 1-15; T1: median 2, range 0-11; p = 0.003; T4 : median 2, range 0-11; p = 0.001) was observed at 1 and 4 weeks after treatment.


Our non-antibiotic quadruple regimen was not as effective as standard triple regimen for H. pylori eradication, and may need further exploration such as extending the treatment duration or replacing with another probiotic. However, significant improvement in dyspeptic symptoms was observed after 1 and 4 weeks after treatment.

Keyword :
H. pylori, quadruple regimen

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