Background and objectives: Four-drugs treatment included of Bismuth–Omperazole–Metronidazole and Amoxicillin have been used as first line treatment for Helicobacter Pylori eradication by many of physician in Iran. However, there is an uncertainty for effectiveness of the regime on patients of Hamadan with the resistance rate of this regime reported in different parts of the country. Present study attempt to evaluate the effectiveness of this regime as first line treatment of H. Pylori in patients of Hamadan..

Method: There are 100 patients with recognized H.pylori infection who could terminate this study. At first, these patients treated by four-drugs regime for 2 weeks, then they treated with Omprazole for 1 month. Successful eradication was determined as negative Urease Test with Carbon 13.

Results: The average of individual ages was 38±11.78 years old. 57% of patients were men. The eradication rate of H.pylori was 80% and the eradication had no significant correlation with the age, gender, clinical symptoms and endoscopic findings.

 Conclusion: Four-drugs treatment included of Omperazole-Metronidazole-Amoxicillin and Bismuth is effective in patients of Hamadan and still could be applicable in H.pylori treatment as the first line treatment