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Optimizing Helicobacter pylori (H. pylori) eradication therapy is fundamental in the era of rising antibiotic resistance.
High-dose PPI–based 10-day concomitant therapy achieves the highest H. pylori eradication rate when compared to standard and reduced-duration regimens.
Optimizing Helicobacter pylori (H. pylori) eradication therapy is fundamental in the era of rising antibiotic resistance. This study explored whether high-dose proton pump inhibitor (PPI) therapy combined with a shorter antibiotic regimen can boost eradication rates, while maintaining safety, potency, and patient adherence.
In this pilot randomized controlled trial, 120 adults with confirmed H. pylori infection (via upper gastrointestinal endoscopy) were enrolled. Overall, 113 eligible volunteers were randomized into the following groups:
The primary outcome, H. pylori eradication, was assessed using the urea breath test 6 weeks following treatment completion.
Out of 120 enrolled subjects, 101 were analyzed (exclusion rate: 15.8%). Pre-randomization exclusions (5.8%) were due to drug allergies, while post-randomization exclusions (12%) were due to loss to follow-up. The high-dose PPI regimen (Group C) illustrated the highest eradication rate, followed by the standard and reduced-duration regimens, as depicted in Table 1:
These findings suggest a potential advantage of high-dose PPI with shorter-duration therapy. However, the 100% eradication rate in Group C should be interpreted cautiously due to the pilot nature and limited sample size.
A 10-day high-dose PPI concomitant regimen appeared to deliver superior H. pylori eradication rates when compared to standard and reduced-duration strategies. This short-duration, high-intensity therapy may improve treatment outcomes and compliance. Nevertheless, larger trials are needed to validate these findings and substantiate their clinical generalizability.
BMC Gastroenterology
Efficacy of 10 days high-dose and double-dose rabeprazole-based concomitant therapy for Helicobacter pylori eradication among Lebanese population: a pilot randomized controlled trial
Marc Elias et al.
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