Taiwan: According to a study published in AJG, American Journal of Gastroenterology, researchers have found 14-day hybrid therapy and 10-day bismuth quadruple therapy to be more effective in treating H. pylori infection than the 14-day high-dose dual therapy as the first-line treatment.
Researchers comparatively evaluated how safe and efficacious 14-day hybrid therapy, 14-day high-dose dual therapy, and 10-day bismuth quadruple therapy are for managing H. pylori infections in the first-line treatment.

They recruited patients with relevant histories from nine centres in Taiwan and randomly assigned them in a ratio of 1:1:1 to the three aforementioned therapies. The rate of eradication of H pylori assessed in the intention-to-treat population was the primary outcome measured in the study.
The study results could be summarised as follows:
Nine hundred eighteen patients were assigned randomly (August 2018-December 2021).
The intention-to-treat eradication rates for 14-day hybrid therapy, 14-day high-dose dual therapy and 10-day bismuth quadruple therapy were 91.5%, 83.3% and 90.2%, respectively.
Both hybrid therapy (difference: 8.2%) and bismuth quadruple therapy (difference: 6.9%) were superior to high-dose dual treatment, and there were similarities to one another.
The adverse events frequency for 14-day hybrid therapy, 14-day high dose dual therapy, and 10-day bismuth quadruple therapy was 27%, 13% (40/305) and 32%, respectively.
There were few adverse events in patients receiving high-dose dual therapy.
Concluding further, as per the study studies findings, there was more effectiveness reported with 14-day hybrid therapy, and 10-day bismuth quadruple therapy is more effective compared to 14-day high-dose dual therapy in the first-line treatment of H. pylori infection in Taiwan.
The researchers also reported that there are few side effects with high-dose dual therapy compared to the hybrid bismuth quadruple treatments.
Further reading:
Hsu, Ping-I et al. Hybrid, high-dose dual and bismuth quadruple therapies for first-line treatment of Helicobacter pylori infection in Taiwan: a multicenter, open-label, randomized trial. The American Journal of Gastroenterology ():10.14309/ajg.0000000000002255, March 20, 2023. | DOI: 10.14309/ajg.0000000000002255