{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:15:37Z","timestamp":1792278937565,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":46,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["26010182235154"],"award-info":[{"award-number":["26010182235154"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Penicillin allergy significantly restricts therapeutic options for <jats:styled-content style=\"fixed-case\"><jats:italic>Helicobacter pylori<\/jats:italic><\/jats:styled-content> eradication. This multicenter randomized controlled study was designed to evaluate the efficacy and safety of a novel cefuroxime\u2013tetracycline\u2010containing bismuth quadruple therapy (Cef\u2010Tet BQT) as first\u2010line treatment in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Penicillin\u2010allergic treatment\u2010na\u00efve patients with confirmed <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection (<jats:italic>N<\/jats:italic>\u2009=\u2009248) were randomized to two 14\u2010day regimens: one received Cef\u2010Tet BQT (Tegoprazan 50\u2009mg twice a day, bismuth potassium citrate 220\u2009mg twice daily, cefuroxime 500\u2009mg twice daily, tetracycline 500\u2009mg three times daily), and the other received cefuroxime\u2013levofloxacin\u2010containing bismuth quadruple therapy (Cef\u2010Lev BQT: cefuroxime 500\u2009mg twice daily, levofloxacin 500\u2009mg once daily). The primary endpoint assessed noninferiority of eradication rates, with secondary endpoints including safety profiles and adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 248 patients underwent randomization. The intention\u2010to\u2010treat (ITT) eradication rates were 90.32% (112\/124, 95% confidence interval [CI]: 85.12%\u201395.52%) and 81.45% (101\/124, 95% CI: 74.61%\u201388.29%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.045); the modified intention\u2010to\u2010treat (MITT) eradication rates were 91.80% (112\/122, 95% CI: 86.93%\u201396.67%) and 83.47% (101\/121, 95% CI: 76.85%\u201390.09%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.048); and the per\u2010protocol (PP) eradication rates were 92.37% (109\/118, 95% CI: 87.58%\u201397.16%) and 85.34% (99\/116, 95% CI: 78.90%\u201391.78%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.087) in the Cef\u2010Tet BQT group and Cef\u2010Lev BQT group, respectively. Noninferiority of the Cef\u2010Tet BQT group was demonstrated in all three analyses (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The incidence of adverse events (21.77% vs. 24.19%) and compliance (96.77% vs. 95.97%) were comparable between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BQT containing cefuroxime and tetracycline is efficacious and safe for the first\u2010line eradication of <jats:italic>H. pylori<\/jats:italic> in penicillin\u2010allergic patients. This regimen provides a viable alternative to circumvent the antimicrobial resistance concerns associated with levofloxacin\u2010based regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> ID: NCT06351891<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.70033","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T10:27:01Z","timestamp":1744799221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Efficacy and Safety of Cefuroxime\u2013Tetracycline\u2010Containing Bismuth Quadruple Therapy for <scp><i>Helicobacter pylori<\/i><\/scp> Eradication in Penicillin\u2010Allergic Patients: A Multicenter Randomized Controlled Trial"],"prefix":"10.1111","volume":"30","author":[{"given":"Hui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Qilu Hospital of Shandong University  Jinan Shandong China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease  Jinan Shandong China"},{"name":"Laboratory of Translational Gastroenterology Qilu Hospital of Shandong University  Jinan Shandong China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor Qilu Hospital of Shandong University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingzhou","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Qilu Hospital of Shandong University  Jinan Shandong China"},{"name":"Shandong Provincial Clinical Research Center for Digestive Disease  Jinan Shandong China"},{"name":"Laboratory of Translational Gastroenterology Qilu Hospital of Shandong University  Jinan Shandong China"},{"name":"Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor Qilu Hospital of Shandong University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiumei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Traditional Chinese Medicine Hospital of Yuncheng County  Heze Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Qihe County People's Hospital  Dezhou Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruili","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Taierzhuang District People's Hospital  Zaozhuang Shandong 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