Efficacy of Tegoprazan-Amoxicillin vs BQT therapy in the treatment of H.pylori

Helicobacter pylori (H. pylori) infection remains a global health concern, directly implicated in peptic ulcer disease, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and the development of gastric adenocarcinoma. Despite the universal recommendation for eradication, the efficacy of standard first-line therapies, such as Proton Pump Inhibitor (PPI)-based triple therapy, has precipitously declined worldwide due to rising antimicrobial resistance, particularly to clarithromycin and metronidazole [1]. To counteract this resistance, current international consensus guidelines, including the Maastricht VI/Florence and American College of Gastroenterology (ACG) recommendations, prioritize high-efficacy regimens. The Bismuth Quadruple Therapy (BQT) (a PPI, bismuth salt, and two antibiotics, often tetracycline/amoxicillin and metronidazole/furazolidone) has emerged as a cornerstone of first-line and salvage therapy, achieving generally high eradication rates [2]. However, BQT is hampered by a complex, high-pill burden regimen, frequent adverse events (AEs), and concerns about patient compliance, which can limit its real-world effectiveness [3].