Optimal length of triple therapy for H pylori eradication in a population with high prevalence of infection in Chile

• Published in: World journal of gastroenterology : WJG Vol. 13; no. 21; pp. 2967 - 2972
• Main Authors: Riquelme, Arnoldo, Soza, Alejandro, Pedreros, Cesar, Bustamante, Andrea, Valenzuela, Felipe, Otarola, Francisco, Abbott, Eduardo, Arellano, Marco, Medina, Brenda, Pattillo, Alejandro, Greig, Douglas, Arrese, Marco, Rollan, Antonio
• Format: Journal Article
• Language: English
• Published: United States Department of Gastroenterology, Pontificia Universidad Católica de Chile%Hospital de Urgencia Asistencia Pública,Santiago, Chile%Department of Internal Medicine, Pontificia Universidad Católica de Chile 07-06-2007; Baishideng Publishing Group Co., Limited
• Subjects: Adult; Amoxicillin - administration & dosage; Anti-Bacterial Agents - administration & dosage; Chile - epidemiology; Clarithromycin - administration & dosage; Drug Administration Schedule; Drug Therapy, Combination; Female; Helicobacter Infections - drug therapy; Helicobacter Infections - epidemiology; Helicobacter pylori - drug effects; Humans; Male; Middle Aged; Omeprazole - administration & dosage; Prevalence; Rapid Communication; Treatment Outcome; Chile; Omeprazole; Antibiotic treatment; Clarithromycin; Helicobacter pylori; Quasirandomized controlled trial; Amoxicillin
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v13.i21.2967

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.
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.
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.
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.