Background: Although triple therapy with one PPI and two antibiotics for one week has been introduced as the treatment of choice, quadruple therapy in Iran is the standard treatment due to the organism’s high resistance to treatment.
Objective: Comparison of three different PPIs; esomeprazole, lansoprazole and omeprazole with a longer duration (10 days) for eradication of H. pylori in the Iranian population
Methods and Materials: patients with endoscopic evidence of peptic ulcer, non-ulcer dyspepsia, gastritis or acid reflux and confirm H. pylori, either by histology or a positive urea test will randomly divide into three groups; namely, group I receive omeprazole, clarithromycin and and amoxicillin (OCA); group II receive lansoprazole (LCA) and group III receive esomeprazole (NCA) instead of omeprazole. response to treatment will define as eradication of H. pylori confirm by negative C14 urea.
Inclusion/exclusion criteria :Three hundred patients with confirm pylori infection by histology and urea test will enroll in the study.Exclusion criteria includ previous treatment of H. pylori infection, previous use of any antibiotics or bismuth subcitrate or any PPI or H2 blockers within four weeks prior to endoscopy, use of NSAIDs for more than four weeks, history of allergy to medications, previous history of any gastric surgery, underlying diseases such as cirrhosis or uremia and pregnancy.
Outcome measure: Patients come to the clinic one week after completion of the treatment to be evaluate for any potential drug side effect and also to be check for their compliance. To evaluate the efficacy of H. pylori eradication therapy, patients were examine with C14 urea respiratory test 40 days after completion of the treatment course. A questionnaire will use for each patient including the patient’s symptoms, endoscopic findings, H. pylori status by urea test, pathology report and medication side effect. Side effects will systematically record throughout the study and will assess using a checklist administer by a physician and describe as
1-None or only mild: mild discomfort which don’t interfere with the patients’ normal daily activities
2-Intermediate: discomfort or side effects which interfer with the patients’ normal daily activities.
3-Severe: side effects requiring cessation of treatment.
We use ITT analysis to compare eradication of H. pylori in all the patients in the three study groups without considering their compliance. In addition, we perform per-protocol analysis to compare the eradication for all the patients