Efficacy of Helicobacter pylori Eradication Based on Rabeprazole-Bismuth-Tetracycline-Tinidazole Regimen in Vietnamese Patients with Duodenal Ulcers

(1) Background: In Vietnam, H. pylori bacteria has a resistance rate of 63% to the antibiotic clarithromycin. The initial therapy of H. pylori eradication with a standard three-drug regimen has low efficacy. Objective: Assess the efficacy of H. pylori eradication therapy which uses a four-drug regimen of rabeprazole-bismuth-tetracycline-tinidazole in patients with duodenal ulcers. (2) Methods: We performed gastrointestinal endoscopy on patients with a diagnosis of duodenal ulcers, gastric mucosa biopsy for a rapid urease test, and histopathology to diagnose H. pylori bacteria before and after treatment. Treatment for eradication of H. pylori bacteria using a rabeprazole-bismuth-tetracycline-tinidazole regimen was prescribed for 14 days. (3) Results: The rate of successful H. pylori eradication treatment according to per protocol (PP) and intention to treat (ITT) was 91.3% (95%CI: 84.8-96.7) and 82.4% (95%CI: 74.5-89.2) respectively. The success rate of H. pylori eradication therapy in males was 96.0% (95%CI: 92-100), higher than in females, which was 70.6% (95%CI: 47.1-88.2), p < 0.01. (4) Conclusions: Treatment of H. pylori with rabeprazole-bismuth-tetracycline-tinidazole regimen is highly effective. Men had higher H. pylori eradication results than women.