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Triple vs. quadruple regimens for H. pylori eradication in peptic ulcer disease

Peptic ulcer Peptic ulcer
Peptic ulcer Peptic ulcer

Helicobacter pylori (H. pylori) is the leading cause of peptic/stomach ulcer disease, necessitating effective eradication regimens.

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Key take away

Omeprazole (proton-pump inhibitor) 20 mg, Amoxicillin (penicillin antibiotic) 500 mg, Levofloxacin (broad-spectrum antibiotic) 500 mg regimen offers high efficacy and safety for H. pylori eradication in peptic ulcer disease with excellent patient adherence.

Background

Helicobacter pylori (H. pylori) is the leading cause of peptic/stomach ulcer disease, necessitating effective eradication regimens.

This randomized, open-label trial compared the efficacy of three anti-H. pylori regimens in peptic ulcer disease patients based on C14 urease breath test outcomes, compliance, and unfavourable effects. The objective was to evaluate the effectiveness of these treatments for H. pylori infection.

Method

A total of 136 treatment-naive H. pylori-infected patients were assigned to one of the three groups:

  • OAC group: Patients received Omeprazole 20 mg, Amoxicillin 500 mg, and Clarithromycin 500 mg, each given twice daily for 14 days
  • OAL group: Patients received Omeprazole 20mg, Amoxicillin 500 mg, Levofloxacin 500 mg, also given each twice daily for 14 days
  • OAMB group: Patients received Omeprazole 20 mg, Amoxicillin 500 mg, Metronidazole 500 mg three times daily, along with Bismuth 240 mg twice daily for 14 days

Compliance and adverse drug effects were monitored at 2 weeks, and H. pylori eradication was assessed 8 weeks post-treatment using the C14 urease breath test.

Result

The study included patients matched by age and sex across the treatment groups. C14 urease breath test results revealed H. pylori eradication rates of 82.2%, 91.3%, and 97.3% for the OAC, OAMB, and OAL regimens, respectively. All treatments demonstrated high patient compliance. A significant difference in eradication rates was found only between OAC and OAL, with no dominance noted between OAMB and either OAL or OAC therapies.

Conclusion

The OAL eradication regimen for H. pylori infection proved to be successful in patients with peptic ulcer disease, demonstrating high efficacy and excellent tolerance, with no reported acute side effects.

Source:

Reviews on Recent Clinical Trials

Article:

The Efficacy of Two Triple Therapy Regimens and One Quadruple Regimen [Omeprazole, Amoxicillin, Metronidazole with Bismuth] in Eradicating Helicobacter Pylori in Patients with Peptic Ulcer: A Randomized Clinical Trial

Authors:

Amir Mohammad Salehi et al.

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