COMPARISON OF A 10 DAY TRIPLE AND A TWO-WEEK QUADRUPLE THERAPY IN ERADICATING HELICOBACTER PYLORI INFECTION IN PATIENTS REFERRED TO IMAM KHOMEINI HOSPITAL CLINICS AHWAZ, IRAN

Helicobacter pylori eradication has become the standard treatment for peptic ulcer disease. It is also indicated in cases with atrophic gastritis, and following gastric cancer resection. Many short-term (one week) triple therapy regimens suffer from the problem of resistance. The aim of the present study was to evaluate the clinical efficacy and safety, patient compliance and tolerability of a 10 days triple therapy versus 2 week conventional therapy in patients with peptic ulcer disease or chronic gastritis in eradicating Helicobacter pylori infection. A total of 160 H. pylori-positive patients suffering from peptic ulcer disease or chronic gastritis without previous treatment were enrolled in the study and randomly allocated into the following two groups: group A (n = 85) received a 2 week quadruple therapy regimen using omeprazole, amoxicillin, bismuth subcitrate and metronidazole (BOMA); group B (n = 75) received a 10-d triple therapy 20 mg omeprazole b.i.d., 1000 mg amoxicillin b.i.d., 500 mg clarithromycin b.i.d. (OAC), (before breakfast and dinner). Eradication verified with UBT technique 8 weeks after completion of the therapy. Three cases were lost to follow-up one from group A (B-OAM) and two cases from group B (OAC). H. pylori eradication rates produced by B-OAM and OAC were 61% and 78% respectively based on an intention to treat analysis, and 63% versus 81% respectively based on a per-protocol analysis. The triple protocol yielded higher eradication rate by both per-protocol and intention-to-treat analyses. 10 day triple therapy regimen achieves an H. pylori eradication rate superior to that of a 2-week quadruple therapy and is associated with comparable patient compliance and complications but we achieved relatively low eradication rates and further investigations are needed in Khuzestan area.