Prevention

Quadruple therapy: ^a

• a proton-pump inhibitor plus amoxicillin, clarithromycin and a nitroimidazole ^a
• a bismuth compound and a proton-pump inhibitor plus amoxicillin and clarithromycin ^a  

• A 3-day quadruple therapy eradication course is as effective as a 7-day triple therapy course ^a  
• A 5 day quadruple therapy course leads to a higher cure rate but more diarrhoea than a 7-day triple therapy course.^a  

Quadruple therapy increases cure rates but causes more diarrhoea than triple therapy

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
dypepsia or peptic ulcers with H. pylori infection o a	quadruple therapy for 5 days	triple therapy for 7 days	cured at 4 weeks	81%	14% (1% to 29%)	9 (5 to 110)
			diarrhoea or soft stool at 4 weeks	7.5%	-250% (-720% to -49%)	-5 (-13 to -3)