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Comparison Between 10‐ and 14‐Day Hybrid Regimens for H elicobacter pylori Eradication: A Randomized Clinical Trial
Author(s) -
Metanat Hassan Ali,
Valizadeh Seyed Mohammad,
Fakheri Hafez,
Maleki Iradj,
Taghvaei Tarang,
Hosseini Vahid,
Bari Zohreh
Publication year - 2015
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12202
Subject(s) - medicine , regimen , clarithromycin , helicobacter pylori , amoxicillin , discontinuation , gastroenterology , tinidazole , intention to treat analysis , pantoprazole , confidence interval , urea breath test , surgery , randomized controlled trial , omeprazole , helicobacter pylori infection , antibiotics , metronidazole , microbiology and biotechnology , biology
Background H elicobacter pylori ( H . pylori ) eradication has always been a concern. In our pervious study, 14‐day hybrid regimen showed ideal results. Based on these findings, we decided to compare the efficacy of 10‐ and 14‐day hybrid regimens for H . pylori eradication. Methods Two hundred and seventy patients with peptic ulcer disease and H . pylori infection were enrolled in the study. One hundred and thirty‐four patients received 10‐day hybrid regimen ( PACT ‐10): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice daily for 10 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just during the last 5 days. One hundred and thirty‐six patients received 14‐day hybrid regimen ( PACT ‐14): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice a day for 14 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just for the last 7 days. Eight weeks after treatment, 14 C‐urea breath test was performed to evaluate H . pylori eradication. Results Two hundred and fifty patients (124 patients in PACT ‐10 and 126 patients in PACT ‐14 regimens) completed the study. The intention‐to‐treat eradication rates were 77.6% (95% confidence interval ( CI ): 70.6–84.6%) and 86% (95% CI : 80–92%) for the two regimens, respectively ( p = .17). Per‐protocol eradication rates were 83.8% (95% CI : 80–86%) and 92.8% (95% CI : 88–96%), respectively ( p < .01). There were no significant intergroup differences in compliance to treatment or discontinuation of therapy due to severe side effects. Conclusion Ten‐day hybrid regimen could not achieve acceptable eradication rate. However, 14‐day hybrid regimen seems to be an acceptable option for H . pylori eradication in Iran.