H. pylori eradication rates with a ready-to-use triple therapy set (Pylobact AM) were 90.6% for standard therapy and 97.03% for therapy enhanced with bismuth, probiotics, and/or rebamipide, with high patient and physician satisfaction ratings in real-world clinical practice.
Key Findings
Results
H. pylori eradication rates differed between standard triple therapy and enhanced regimens in the ITT analysis.
Eradication rate in the PAM (standard triple therapy) group was 90.6% by ITT analysis.
Eradication rate in the PAMplus group (enhanced with bismuth, rebamipide, and/or probiotic) was 97.03% by ITT analysis.
Eradication rate in the PAM+Bi+F subgroup (triple therapy plus bismuth and Floriose synbiotic complex) was 96.82% by ITT analysis.
870 patients completed the observational program: 538 in the PAM group and 332 in the PAMplus group.
Results
Treatment significantly reduced GSRS abdominal pain scores during the course of therapy.
Symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire.
The paper reports that 'treatment significantly reduced GSRS abdominal pain scores.'
Symptom assessment was conducted at baseline and at end of the observational program.
Results
Physicians rated treatment efficacy and tolerability highly at the end of the observational program.
Physicians rated the treatment efficacy and tolerability as 'very good' or 'good' in 93.3% of patients at the end of the program.
Ratings were assessed using a five-point Likert scale.
912 H. pylori-positive patients were initially included (404 men, 508 women, average age 43.82±11.39 years, range 18–64 years).
Results
Patient satisfaction with treatment was high, with the majority completely or mostly satisfied.
93.68% of patients reported being completely or mostly satisfied with the treatment.
Patient satisfaction was self-assessed at the end of the observational program.
All patients had duodenal ulcer disease in the acute or remission stage.
Methods
A subgroup received triple therapy augmented with bismuth tricitrate and the synbiotic complex Floriose containing multiple probiotic strains.
The PAM+Bi+F subgroup received standard triple therapy plus bismuth tricitrate and Floriose synbiotic complex.
Floriose contained probiotic strains Lactobacillus acidophilus La-14, Lactobacillus rhamnosus Lr-32, and Bifidobacterium lactis Bl-04, along with inulin and B vitamins.
This subgroup achieved an ITT eradication rate of 96.82%.
Methods
H. pylori eradication was confirmed using multiple validated diagnostic methods.
Eradication was assessed by 13C-urea breath test, H. pylori antigen stool test, or rapid urea test with biopsies of the gastric body and antrum obtained during upper endoscopy.
912 patients were enrolled and 870 completed the program, representing a completion rate of approximately 95.4%.
The standard triple therapy regimen consisted of omeprazole 20 mg × 2, clarithromycin 500 mg × 2, and amoxicillin 500 mg × 4 (Pylobact AM).
What This Means
This research studied how well a pre-packaged H. pylori eradication treatment (containing omeprazole, clarithromycin, and amoxicillin, sold as Pylobact AM) worked in everyday clinical practice across 912 patients with duodenal ulcer disease in Russia. The study found that the standard three-drug treatment successfully eliminated H. pylori in about 90.6% of patients, which is already a high success rate. When doctors added extra medications such as bismuth (a stomach-protective mineral), probiotics (beneficial bacteria), or rebamipide (a gut-protective drug), the success rate climbed even higher, to around 97%.
Beyond just killing the bacteria, the treatment also noticeably reduced patients' stomach pain as measured by a validated symptom questionnaire (GSRS). Both patients and doctors reported high satisfaction: over 93% of physicians rated the treatment's effectiveness and tolerability as 'good' or 'very good,' and nearly 94% of patients said they were completely or mostly satisfied with their treatment.
This research suggests that using a ready-to-use, pre-packaged treatment kit helps patients take their medications correctly, which likely contributes to the high eradication rates seen in real-world settings. It also suggests that adding bismuth, probiotics, or rebamipide to standard triple therapy may further improve outcomes for patients with H. pylori infection and duodenal ulcers.
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Alexeev N, Astaf'eva T, Vishnevskaya V, Donchenko N, Zhuravleva V, Kruglova P, et al.. (2026). [Efficacy and safety of H. pylori eradication therapy in real-world clinical practice: results of the «PAMIR» observational program].. Terapevticheskii arkhiv. https://doi.org/10.26442/00403660.2026.08.203756