Comparative Study between Two Triple-therapy Regimens in Treating Helicobacter pylori: Related Peptic Ulcer Disease

Abstract

Background: Helicobacter pylori (H. pylori) infection has increased worldwide and it is found to be positive in more than 50% of the specimens taken during endoscopy. The goal of the study is to compare the efficacy of two triple-therapy regimens in eradication of H. pylori and to evaluate the cost factor involved. Aims:• To compare and study between two triple-therapy regimens in treating (H. pylori)-related peptic ulcer disease.• To find the cost efficacy between two triple-therapy regimens. Materials and methods: A randomized single-blinded study was conducted at a tertiary care hospital from 2016 to 2018. Upper gastrointestinal endoscopy was performed on all the patients after spraying them with a topical local anesthetic agent (10% lignocaine spray). Two biopsy specimens were taken from the antrum of the stomach. The rapid urease test (RUT) was considered positive, if a color change from yellow to pink was noted in the RUT kit within 10 minutes. The sample size was calculated and fixed at 60. The RUT-positive patients were divided into two groups by computer-generated random allotment. Group I patients were started on regimen I comprising omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, and amoxicillin 1,000 mg twice daily for 2 weeks. Group II patients were started on regimen II: OCM: omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, and metronidazole 400 mg twice daily for 2 weeks. The endoscopic RUT was performed in the beginning and after 6 weeks to check for eradication of H. pylori. The ethical committee approval was obtained (IEC no. 2017/308) and data were collected using a proforma and were entered in the Excel sheet. The statistical analysis was done by SPSS (version 23). Descriptive statistics regarding age, sex, and inference with regimens were calculated and recorded. Results: Among the patients administered regimen I, H. pylori was eradicated in 27 (90%). And among the patients administered regimen II, H. pylori was eradicated in 28 (93.3%). This difference was not statistically significant with p value of 0.323. However, it was observed that regimen II was cheaper than regimen I.