title: Comparing the efficacy of four different protocols for eradicating of Helicobacter pylori infection in Ahvaz, southwest Iran.
abstract: BACKGROUND
  Helicobacter pylori (H. pylori) is the common cause of many gastrointestinal diseases, especially peptic ulcer. Therefore, a successful treatment of this infection decreases the financial burden on health systems.
  
  
  OBJECTIVE
  Different combinations of antibiotics are used for the eradication of this bacterium worldwide. The goal of this study is to compare the efficacy of four different protocols used for this purpose in Ahvaz.
  
  
  METHODS
  A total number of 400 patients with H. pylori infection were randomly divided into four groups (100 in each): (1) OAC: omeprazole (20 mg/b.i.d.), amoxicillin (1000 mg/b.i.d.), clarithromycin (500 mg/b.i.d.) for 10 days. (2) OCF: omeprazole (20 mg/b.i.d.), ciprofloxacin (500 mg/b.i.d.), furazolidone (100 mg/b.i.d.) for 10 days. (3) OBAM: omeprazole (20 mg/b.i.d.), bismuth subcitrate (240 mg/b.i.d.), amoxicillin (1000 mg/b.i.d.), metronidazol (500 mg/b.i.d.) for 14 days. (4) OBTM: omeprazole (20 mg/b.i.d.), bismuth subcitrate (240 mg/b.i.d.), tetracycline (500 mg/b.i.d.), metronidazol (500 mg/b.i.d.) for 14 days. At the end the viability of the bacterium was assessed by C(14) urea breath test.
  
  
  RESULTS
  The rate of H. pylori eradication was 92%, 59%, 73%, and 76% in OAC, OCF, OBAM, and OBTM groups, respectively (based on intention to treat analysis). The eradication rate was 93.9%, 62.1%, 77.7%, and 84.4% in OAC, OCF, OBAM, and OBTM groups, respectively (based on per protocol analysis). There was a statistically significant increase in eradication rate in the OAC group in comparison with the others (p < 0.001).
  
  
  CONCLUSIONS
  Standard triple therapy (omeprazole, amoxicillin, clarithromycin) remains the most effective regimen for H. pylori eradication in Ahvaz.
authors.affiliation: Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Abdolrahim
authors.initials: A
authors.lastname: Masjedizadeh
authors.affiliation: Research Center for Infectious Diseases of Digestive System, Departement of Pharmacology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Narjes
authors.initials: N
authors.lastname: Zaeemzadeh
authors.affiliation: Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Seyyed Ali
authors.initials: SA
authors.lastname: Mard
authors.affiliation: Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Ghazal Salehi
authors.initials: GS
authors.lastname: Vanani
keywords: Ahvaz; Helicobacter pylori; bismuth subcitrate; ciprofloxacin; clarithromycin; metronidazol