# Novel non-antibiotic triple therapy for Helicobacter pylori-positive functional dyspepsia patients resistant to conventional antibiotic treatments: an exploratory pilot study

**Authors:** Canyu Zhan, Yurong Huang, Zhengyi Yang, Hua Wu, Juan Zheng, Wangliu Yang, Junjie Rao, Gengqing Song, Jie Yang

PMC · DOI: 10.3389/fmed.2026.1759043 · Frontiers in Medicine · 2026-02-11

## TL;DR

This study explores a new non-antibiotic treatment for stomach infections in patients who no longer respond to standard antibiotic therapies.

## Contribution

A novel non-antibiotic triple therapy is proposed for H. pylori-positive functional dyspepsia patients resistant to conventional treatments.

## Key findings

- 72.9% of patients achieved successful H. pylori eradication after 14 days of treatment.
- 77.08% of patients experienced symptom relief, with minimal adverse effects reported.
- High compliance (91.67%) and mild adverse reactions suggest the therapy is well-tolerated.

## Abstract

The rising antibiotic resistance has significantly reduced the efficacy of standard bismuth-based quadruple therapy for Helicobacter pylori (H. pylori) infections, particularly in patients with multiple eradication failures. This study evaluates a novel non-antibiotic triple therapy comprising Weisu granules, berberine hydrochloride, and Bio-Three—a probiotic formulation containing Clostridium butyricum TO-A, Enterococcus faecalis T-110, and Bacillus mesentericus TO-A—in treating H. pylori-positive functional dyspepsia (FD) patients resistant to conventional antibiotic treatments.

A two-center retrospective analysis involved 48 FD patients who had previously failed at least two H. pylori eradication therapies. Participants underwent a 14-day course of non-antibiotic therapy, with primary endpoints being H. pylori eradication rate, assessed via 14C urea breath test, and secondary endpoints including symptom relief and adverse reactions.

Successful H. pylori eradication was achieved in 72.9% (35/48) of patients. Symptom relief was observed in 77.08% of cases, with 43.75% achieving effective improvement and 33.33% marked improvement. Adverse reactions were mild, occurring in 8.3% (4/48) of patients, including abdominal distension, dry mouth, and nausea, all resolving spontaneously. The compliance rate was high at 91.67%.

This study provides preliminary evidence supporting the use of non-antibiotic triple therapy as an alternative for managing H. pylori infections in FD patients resistant to conventional antibiotic treatments, demonstrating notable eradication rates and symptom relief with minimal adverse effects. Further research is warranted to explore its mechanisms, long-term efficacy, and potential integration into existing treatment paradigms.

## Linked entities

- **Chemicals:** berberine hydrochloride (PubChem CID 12456)

## Full-text entities

- **Diseases:** gastrointestinal and extraintestinal disorders (MESH:D005767), peptic ulcer (MESH:D010437), hypertension (MESH:D006973), brain-gut interaction disorder (MESH:D001927), chronic gastritis (MESH:D005756), Dyspepsia (MESH:D004415), decreased appetite (MESH:D001068), drug allergies (MESH:D004342), gastrointestinal tumor (MESH:D005770), positive (MESH:D000377), abdominal distension (MESH:D000007), dry mouth (MESH:D014987), abdominal pain (MESH:D015746), epigastric pain (MESH:D010146), H. pylori infection (MESH:D016481), respiratory and gastrointestinal infections (MESH:D012141), duodenal inflammation (MESH:D007249), gastrointestinal symptom (MESH:D012817), esophagitis (MESH:D004941), cerebrovascular accident (MESH:D020521), nausea (MESH:D009325), gastric cancer (MESH:D013274)
- **Chemicals:** urea (MESH:D014508), cefuroxime (MESH:D002444), Bismuth (MESH:D001729), 13C urea (-), short-chain fatty acids (MESH:D005232), Berberine (MESH:D001599), rabeprazole (MESH:D064750), flavonoids (MESH:D005419), minocycline (MESH:D008911), furazolidone (MESH:D005664), 14C (MESH:C000615234), hesperidin (MESH:D006569), esomeprazole (MESH:D064098), clarithromycin (MESH:D017291), bismuth potassium citrate (MESH:C002791), 13C (MESH:C000615229), amoxicillin (MESH:D000658), volatile oils (MESH:D009822)
- **Species:** Clostridioides difficile (species) [taxon 1496], Homo sapiens (human, species) [taxon 9606], Helicobacter pylori (species) [taxon 210], Citrus reticulata (mandarin orange, species) [taxon 85571], Cyperus rotundus (species) [taxon 512623], Gallus gallus (bantam, species) [taxon 9031], Areca catechu (areca-nut, species) [taxon 184783], Perilla frutescens (beefsteak-mint, species) [taxon 48386], Escherichia coli (E. coli, species) [taxon 562], Heyndrickxia coagulans (species) [taxon 1398], Coptis chinensis (species) [taxon 261450], Clostridium butyricum (species) [taxon 1492]

## Full text

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## Figures

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## References

33 references — full list in the complete paper: https://tomesphere.com/paper/PMC12932454/full.md

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Source: https://tomesphere.com/paper/PMC12932454