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

Abstract

<i>Helicobacter pylorus</i> is one of the most common bacterial infections affecting the world's population. Peptic ulcer disease is caused by <i>H. pylori</i> and the use of nonsteroidal anti-inflammatory drugs. The aim of this study was to assessment of two antibiotic regimens in the treatment of <i>H. pylori</i>. A total of 220 <i>H. pylori</i> 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. 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 (<i>P</i> > 0.05). The eradication rates at bismuth-containing quadruple therapy group were 77.2% and 76.1%, respectively, (<i>P</i> > 0.05). Also, there were no significant differences in the compliance rates and adverse effects between two groups (<i>P</i> > 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. 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.