Authors (including presenting author) :
Tsang SC(1), Ma YK(2), Tai BBW(3)
Affiliation :
(1)Department of Pharmacy, Tuen Mun Hospital, (2)Department of Medicines and Geriatrics, Tuen Mun Hospital, (3)School of Pharmacy, The Chinese University of Hong Kong
Introduction :
Choice of H. pylori infection regimen is essential as successful eradication can prevent complications such as gastric cancer and peptic ulcer diseases. Triple therapy and concomitant quadruple therapy are both first-line treatments in Hong Kong, this study aims to evaluate the clinical effectiveness in eradication rate between these two regimens.
Objectives :
To investigate the difference in treatment effectiveness of triple therapy and concomitant quadruple therapy in H. pylori infection by comparing the differences in eradication rate using urea breath test (UBT).
Methodology :
A single centred cross-sectional retrospective study was performed, using the urea breath test attendance records as patient recruitment tool. Eligible patients were grouped with treatment with triple therapy (amoxicillin 1000 mg BD + clarithromycin 500 mg BD + standard dose proton pump inhibitor BD) and concomitant quadruple therapy (amoxicillin 1000 mg BD + clarithromycin 500 mg BD + metronidazole 400–800 mg BD + standard dose proton pump inhibitor BD) as their first treatment of H. pylori infection. The eradication rate between the two groups was compared, and their treatment-related adverse effects and gastrointestinal-related hospitalization were analyzed.
Result & Outcome :
369 patients were treated with triple therapy with eradication rate of 80.2% and 109 were treated with concomitant quadruple therapy with eradication rate of 87.2% (p = 0.099). The one-year GI-related hospitalization (5.1% vs. 5.5%, p = 0.884) and reported adverse effects (0.8% vs. 0%) between the two groups were similar.
Triple therapy and concomitant quadruple therapy has similar clinical effectiveness and concomitant quadruple therapy might be more preferred due to comparable safety and tolerability profiles. Eradication rate of triple therapy is lower than treatment standard and is worth drawing attention to. Larger scale of prospective study and local resistance pattern study of H. pylori are warranted to guide a better choice of first-line regimen in Hong Kong.
