Tier 2 — strong

A randomized, multicenter and noninferiority study of amoxicillin plus berberine vs tetracycline plus furazolidone in quadruple therapy for Helicobacter pylori rescue treatment

Zhang J, Han C, Lu WQ, Wang N, Wu SR, Wang YX, Ma JP, Wang JH, Hao C, Yuan DH, Liu N, Shi YQ

Journal of digestive diseases 2020 21(5):256-263

Bibliography

PubMed: PMID 32348007
PubMed Central: PMC7383804
DOI: 10.1111/1751-2980.12870
Trial registry: View on ClinicalTrials.gov Registered trial — results not yet published in a peer-reviewed journal.
Funding: Indexed support: Booster Plan of XiJing Hospital; Science and Technology Innovation as a Whole Plan Projects of Shaanxi Province. See the publication for grant details.
Competing interests: The publication contains author disclosures. Commercial relationships, employment, funding or other interests should be interpreted from the complete declaration; it is not classified here as conflict-free.

Design	Multicenter open-label randomized noninferiority trial
Model	Human participants; see population
Sample	658 patients after earlier eradication failure
Intervention	Berberine plus amoxicillin, esomeprazole and bismuth versus tetracycline/furazolidone regimen
Duration	14 days; test at 4–8 weeks
Endpoints	Eradication or stool-output outcomes; Treatment tolerability; Adherence

The rescue regimen met a noninferiority criterion, with fewer reported adverse events in the berberine/amoxicillin arm.

The rescue regimen met a noninferiority criterion, with fewer reported adverse events in the berberine/amoxicillin arm.

Both antibiotics and other components differed; cannot attribute the result to berberine alone.

Editorial review

Last verified 22 October 2026