A two-drug, clarithromycin-free H. pylori regimen matched bismuth quadruple therapy in first-line trials

The edition in brief

A meta-analysis of five randomised trials in 1,541 treatment-naive patients found 14-day tegoprazan-amoxicillin dual therapy eradicated H. pylori as often as bismuth quadruple therapy (RR 0.996, 0.911 to 1.089), with adverse events and discontinuation generally less frequent. Because it avoids clarithromycin and metronidazole, it is a potential stewardship gain where resistance to both is common. Pooling 12 catheter-confirmed cohorts of HIV-associated pulmonary arterial hypertension (537 patients, 1986 to 2021) showed severe disease at diagnosis, only 64% on targeted therapy at diagnosis, and survival improving over three decades as treatment use rose. An analysis of counselling notes and electronic dose monitoring in 76 people treated for MDR-TB and HIV in South Africa found bedaquiline and antiretroviral adherence was highest just after a counselling session and fell in the weeks between. The FDA recorded a supplement to a generic itraconazole application on 14 September 2026, an administrative action rather than a new indication or safety finding. The pearl covers itraconazole absorption, interactions and heart failure.