{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:47:41Z","timestamp":1788871661935,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The eradication of Helicobacter pylori (H. pylori) may be difficult due to antibiotic resistance. Indeed, after one failure, a second-line therapy is needed and a bismuth containing quadruple therapy (BQT) with a three-in-one capsule formulation is becoming very popular. Therefore, we aimed to evaluate effectiveness and safety of BQT as a second-line therapy. We recruited consecutive patients with one therapy failure. For ten days patients received the three-in-one BQT Pylera\u00ae therapy, in combination with a proton-pump inhibitor (PPI), decided at the choice of the investigator, at full dose bid. The eradication rate was calculated by intention-to-treat (ITT) and per-protocol (PP)analyses and 95% confidence intervals (CI) were calculated. Seventy-three patients were recruited, 41 females and 32 males (mean age 53.0\u00b113.1 years). Fifty-five patients failed triple therapy with amoxicillin and clarithromycin and the remaining 18 received sequential therapy. Seventy-two patients consumed at least 90% of the capsules, while only one did not complete the therapy due to adverse events (nausea and diarrhea). By ITT analysis, BQT was successful in 62 subjects (eradication rate 84.9%, 95%CI 76.7\u201393.1%). By PP analysis, the eradication rate was 86.1% (95%CI 78.1\u201394.1%).Adverse events were observed in 14 subjects (20.5%).In conclusion, our report confirmed that BQT is effective as an empiric second-line regimen.<\/jats:p>","DOI":"10.3390\/antibiotics11010078","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T17:42:25Z","timestamp":1641836545000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Empiric \u201cThree-in-One\u201d Bismuth Quadruple Therapy for Second-Line Helicobacter pylori Eradication: An Intervention Study in Southern Italy"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7038-3287","authenticated-orcid":false,"given":"Giuseppe","family":"Losurdo","sequence":"first","affiliation":[{"name":"Section of Gastroenterology, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"},{"name":"Ph.D. Course in Organs and Tissues Transplantation and Cellular Therapies, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Lacavalla","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-6072","authenticated-orcid":false,"given":"Francesco","family":"Russo","sequence":"additional","affiliation":[{"name":"Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS \u201cS. de Bellis\u201d Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Riezzo","sequence":"additional","affiliation":[{"name":"Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS \u201cS. de Bellis\u201d Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Brescia","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Rendina","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-5080","authenticated-orcid":false,"given":"Enzo","family":"Ierardi","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Di Leo","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Emergency and Organ Transplantation, University \u201cAldo Moro\u201d of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S0140-6736(96)07023-7","article-title":"Helicobacter pylori infection","volume":"349","author":"Goodwin","year":"1997","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1136\/gutjnl-2015-309252","article-title":"Kyoto global consensus report on Helicobacter pylori gastritis","volume":"64","author":"Sugano","year":"2015","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/ijc.28999","article-title":"Global burden of gastric cancer attributable to Helicobacter pylori","volume":"136","author":"Plummer","year":"2015","journal-title":"Int. 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