Randomized trial of a quadruple-drug regimen and a triple-drug regimen for eradication of Helicobacter pylori: long-term follow-up study.
BACKGROUND
In developing countries, H. pylori eradication rates are suboptimal. A quadruple-drug regimen may improve on the eradication rate achieved with triple-drug regimen.


METHODS
64 consecutive patients with active duodenal ulcer associated with H. pylori infection were randomized to receive either a one-week triple-drug regimen (lansoprazole, clarithromycin, secnidazole) or a one-week quadruple-drug regimen (lansoprazole, amoxycillin, colloidal bismuth subcitrate, secnidazole). H. pylori eradication and ulcer healing were assessed 4 weeks after completion of therapy. Patients were followed up at 24 weeks and 52 weeks for H. pylori recurrence.


RESULTS
Both the regimens eradicated H. pylori in 75% (95% CI 0.6-0.9) of patients. The ulcer-healing rate with the triple-drug regimen was 97% (95% CI 0.91-1.0) and 91% (95% CI 0.91-1.0) with the quadruple-drug regimen. No ulcer or H. pylori recurrence occurred in patients eradicated with the triple-drug regimen, whereas 8.3% of patients eradicated with the quadruple-drug regimen had ulcer as well as H. pylori recurrence during the 52-week follow up.


CONCLUSIONS
Triple-drug regimen achieves similar eradication rates as quadruple-drug regimen in H. pylori infection.
Kumar
D
D
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi.
Ahuja
V
V
Dhar
A
A
Sharma
M P
MP
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000981:Antiprotozoal Agents / Q000008:administration & dosage; D016009:Chi-Square Distribution; D017291:Clarithromycin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008137:Longitudinal Studies; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage; D010406:Penicillins / Q000008:administration & dosage; D011446:Prospective Studies; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D010406:Penicillins; D064747:Lansoprazole; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole; C016724:secnidazole