Eradication efficacy of high-dose amoxicillin and proton pump inhibitor compared with quadruple therapy contained bismuth in the treatment of Helicobacter pylori

Abstract

Background: Helicobacter pylorus is one of the most common bacterial infections affecting the world's population. Peptic ulcer disease is caused by H. pylori and the use of nonsteroidal anti-inflammatory drugs. The aim of this study was to assessment of two antibiotic regimens in the treatment of H. pylori. Methods: A total of 220 H. pylori infected patients were enrolled in the randomized clinical trial that referred to Imam Khomeini Hospital gasterointestinal clinic, Ahvaz. Patients were allocated into two groups randomly. Group 1 received the 14-day proton pump inhibitor (PPI) amoxicillin-containing high-dose therapy and group II received the bismuth-containing quadruple therapy. Basic characteristics, adverse events, and eradication rates were compared between two groups. Results: The PPI–amoxicillin-containing high-dose therapy group achieved eradication rates of 73.6% and 72.4% as determined by the intention-to-treat and per-protocol analyses, respectively (P > 0.05). The eradication rates at bismuth-containing quadruple therapy group were 77.2% and 76.1%, respectively, (P > 0.05). Also, there were no significant differences in the compliance rates and adverse effects between two groups (P > 0.05). Furthermore, the cost of medications in the PPI–amoxicillin-containing high-dose therapy was significantly lower compared with that in the quadruple therapy contained bismuth. Conclusion: PPI–amoxicillin-containing high-dose treatment regimen can be used especially in the pregnancy and lactating patient or low-economic patient because safer and less costly compared with bismuth-containing quadruple therapy.

Keywords

• amoxicillin
• clarithromycin
• eradication rate
• helicobacter pylori
• pantoprazole