Efficacy of minocycline-containing bismuth quadruple therapy for Helicobacter pylori infection: a single-center retrospective study

BACKGROUND: Increasing antibiotic resistance has undermined Helicobacter pylori eradication. Despite a low resistance to minocycline, clinical evidence for minocycline-containing bismuth quadruple therapy (MCQT) limited. This retrospective study aimed to evaluate the clinical efficacy of MCQT. RESEARCH DESIGN AND METHODS: C-urea breath testing at our department from October 2024 to July 2025 were screened. They were classified into MCQT (minocycline-amoxicillin-acid-inhibitors-bismuth [MAAB], minocycline-clarithromycin-acid-inhibitors-bismuth [MCAB], and minocycline-levofloxacin-acid-inhibitors-bismuth [MLAB]) and non-MCQT (amoxicillin-clarithromycin-acid-inhibitors-bismuth [ACAB] and amoxicillin-levofloxacin-acid-inhibitors-bismuth [ALAB]). Four comparisons (MAAB vs. ACAB, MCAB vs. ACAB, MLAB vs. ALAB, and MAAB vs. ALAB) were separately performed in treatment‑naïve and treatment‑experienced patients. Logistic regression analyses were used to identify the influence factors. RESULTS: Overall, 687 treatment-naïve and 92 treatment-experienced Helicobacter pylori patients were included. MAAB demonstrated significantly higher eradication rates than ACAB in both groups (P = 0.020, P = 0.016), with no significant differences in other comparisons. Multivariate logistic regression analysis indicated that female was independently associated with a higher eradication rate in treatment-naïve patients in three comparisons (MAAB vs. ACAB, P = 0.021; MCAB vs. ACAB, P = 0.009; MAAB vs. ALAB, P = 0.043). CONCLUSIONS: MCQT achieve favorable Helicobacter pylori eradication rates in both treatment-naïve and treatment-experienced patients, and MAAB demonstrates a significantly higher eradication rate than ACAB.