Optimal length of triple therapy for H pylori eradication in a population with high prevalence of infection in Chile.
OBJECTIVE
To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile, with a prevalence of 73% in general population.


METHODS
H pylori-infected patients diagnosed by rapid urease test, with non-ulcer dyspepsia or peptic ulcer disease were randomized to receive omeprazole 20 mg bid, amoxicillin 1 g bid, and clarithromycin 500 mg bid for 7 (OAC7) or 14 (OAC14) d. Primary outcome was eradication rate 6 wk after the treatment. Subgroup analysis was carried out considering the eradication rate among patients with or without peptic ulcer disease and eradication rate among smokers or non-smokers.


RESULTS
One hundred and thirty-one patients were randomized to OAC7 (n = 69) or OAC14 (n = 62). The overall eradication rate (intention-to-treat) was 78.3% in OAC7 and 85.5% in OAC14 groups, without a significant difference (P =0.37). No significant difference in the eradication rate was found among the patients with peptic ulcer disease (n = 31) between the OAC7 group (85.7%) and OAC14 group (87.5%). However, smokers had an obviously lower eradication rate compared to non-smokers, particularly in the OAC7 group (57.1% in smokers vs 83.6% in non-smokers; P = 0.06). Adverse effects rate were similar between both groups.


CONCLUSIONS
Short-term efficacy of triple therapy with OAC for 7 d is comparable to 14 d in this high-prevalence population. Longer follow-up, and studies focused to some subgroups of patients (smokers and non-ulcer patients) are necessary to support widespread use of 7-d instead of 10-14-d triple therapy in a developing country like Chile.
Riquelme
Arnoldo
A
Department of Gastroenterology, Pontificia Universidad Católica de Chile, Marcoleta 367, Casilla 114-D, Santiago, Chile. arnoldoriquelme@gmail.com
Soza
Alejandro
A
Pedreros
Cesar
C
Bustamante
Andrea
A
Valenzuela
Felipe
F
Otarola
Francisco
F
Abbott
Eduardo
E
Arellano
Marco
M
Medina
Brenda
B
Pattillo
Alejandro
A
Greig
Douglas
D
Arrese
Marco
M
Rollan
Antonio
A
D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002677:Chile / Q000453:epidemiology; D017291:Clarithromycin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D015995:Prevalence; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole