ABSTRACT
Quadruple therapy appears to be more effective than standard therapy in management of patients with helicobacter pylori infection. No data is available on the relative efficacy of triple and quadruple drug regimens from Pakistan. Consecutive patients with peptic ulcer and H. pylori infection were randomized to receive omeprazole 20 mg twice daily along with either amoxycilline [500 mg four times daily] and clarithromycin [500 mg twice daily] [Group A] or tri-protassium dicitrate hismuthate [120 mg four times daily], metronidazole [400 mg thrice daily] and tetracycline [500 mg 4 times daily] [Group B] for 10 days. Presence H. Pylori infection was looked for using an fecal antigen test before treatment and 30 days after completion of treatment. 17 of 21 patients in Group A and 16 of 23 in Group B had eradication of infection [80.9 and 69.56% respectively by protocol analysis]. Side effects occurred in 2 [1%] and 4[2%] patients in Group A and B, respectively. Discontinuation of drug was not required in any patient. Quadruple therapy for initial therapy of H. Pylori infection does not offer any advantage over standard triple therapy