Table 2.

Clinical Efficacy and Safety.

Clinical Efficacy and Safety
Author and Study	Groups Studied and Intervention	Results and Findings	Conclusions
Study 1: Single Capsule Bismuth Quadruple Therapy for Eradication of H. pylori Infection: A Real-Life Study https://pubmed.ncbi.nlm.nih.gov/33995097/ (accessed on 11 August 2022)	A total of 250 treatment-naïve patients were given esomeprazole 40 mg bid and Pylera 3 tablets QID for 10 days.	13 patients discontinued therapy due to side effects Compliance was greater than 90% Eradication rates were 90.8% 26.8% experienced adverse effects	Using a combination capsule is an effective strategy that improves compliance and yields high eradication rates with low incidence of side effects.
Study 2: Long-term changes in the gut microbiota after triple therapy, sequential therapy, bismuth quadruple therapy, and concomitant therapy for Helicobacter pylori eradication in Chinese children https://pubmed.ncbi.nlm.nih.gov/33899288/ (accessed on 11 August 2022)	16 patients in triple therapy group 15 patients in sequential therapy group 16 patients in bismuth quadruple therapy 16 patients in quadruple therapy Fecal samples were sampled at weeks 0, 2, 6, and 52, and 16S RNA gene sequenced to assess alterations in gut microbiota	All groups showed alterations at week 2 but were restored by week 52 Immediately following treatment in the ST group, Proteobacteria significantly increased	Transient microbiota changes may occur following H. pylori treatment but return to normal within a year to indicate long-term safety.
Study 3: Half-dose clarithromycin-containing bismuth therapy is effective and economical in treating Helicobacter pylori infection: A single-center, open-label, randomized trial quadruple https://pubmed.ncbi.nlm.nih.gov/30780194/ (accessed on 11 August 2022)	210 patients assigned to either half dose clarithromycin (250 mg BID) or standard dose clarithromycin (500 mg BID) containing bismuth quadruple therapy for 14 days UBT performed at 4 weeks post-treatment to assess eradication	Eradication rates were equivalent at 86.67% for both groups The standard-dose group had a higher incidence of side effects at 54.21% vs. 34.29% Lower dose also has an improved cost-effectiveness ratio	A half-dose clarithromycin regimen is as effective as the full dose regimen with improved tolerability and affordability.
Study 4: Efficacy of Lactoferrin with Standard Triple Therapy or Sequential Therapy for Helicobacter pylori Eradication: A Randomized Controlled Trial https://pubmed.ncbi.nlm.nih.gov/34609303/ (accessed on 11 August 2022)	A total of 400 H. pylori-infected patients were either assigned to a triple therapy or sequential therapy group, and each regimen also had a separate group that added bovine lactoferrin for 2 weeks.	Bovine lactoferrin showed improved effectiveness in the sequential therapy and triple therapy (94.5% vs. 82.8% and 85.6% vs. 70.3%).	Bovine lactoferrin could help improve eradication rates as an addition to current regimens.
Study 5: Efficacy and safety of twice a day, bismuth-containing quadruple therapy using high-dose tetracycline and metronidazole for second-line Helicobacter pylori eradication https://pubmed.ncbi.nlm.nih.gov/32074663/ (accessed on 11 August 2022)	A total of 100 patients in each group received either bismuth subcitrate 300 mg QID or BID, tetracycline 1 g, metronidazole 750 mg, and pantoprazole 20 mg BID for 1 week.	The eradication rates between the twice daily and four times daily did not differ (93.9% vs. 92.9%), while adverse effects were more common in the four times daily than twice daily (50 vs. 36).	The twice daily regimen is as effective and safe as the four-times-daily regimen.