The Efficacy of Helicobactor pylori Eradication between PPI based Triple Therapy compared with Concomitant Therapy in patients presenting with Dyspepsia or Peptic ulcer in Banbung Hospital, Chonburi province

Abstract

Background : Drug resistance of organisms were important problem. The first line regimen less efficacy in eradicated Helicobacter pylori infection. This study was designed to evaluated efficacy of PPI based triple therapy compared with alternative drug regimen ; concomitant therapy.

Material & methods : This prospective randomized control study was performed during February 2018 to December 2021. H.pylori infected patients were randomized to received 14 day PPI based triple therapy (omeprazole 20 mg bid, clarithromycin 500 mg bid, amoxycillin 1000 mg bid) or concomitant therapy (omeprazole 20 mg bid, clarithromycin 500 mg bid, amoxycillin 1000 mg bid, metronidazole 500 mg bid). Repeated Esophagogastroduodenoscopy with gastric biopsy was performed at 4 weeks after completely 14 day of each regimen.

Results : A total 118 patients were analyzed for eradication rate. Outcomes was 72% (43/60) with PPI based triple therapy and 69% (40/58) with concomitant therapy (72% VS 69% ; P-value = 0.748). Adverse reactions were revealed in concomitant therapy more than PPI based triple therapy but no statistic significance.

Conclusions : The concomitant therapy not superior to PPI based triple therapy and eradication rate of both regimens under 80%. Choosing new, more effective first line drug regimen for H.pylori eradication was essential in the future.