Helicobacter Pylori Infection Clinical Trial
Official title:
Efficacy of High-dose Dual Therapy Versus Bismuth-containing Quadruple Therapy for Rescue Treatment of Helicobacter Pylori Infection - A Prospective, Randomized, Comparative Study
Up to now, there is few randomized, large scale study prospectively and simultaneously
comparing the efficacy, adverse effects and patient adherence of high-dose dual therapy
(HDDT) and bismuth-containing quadruple therapy (BQT) as rescue regimens for H. pylori
eradication.
The aims of this study are:
1. to compare the efficacy of HDDT, and BQT as rescue regimen in H. pylori eradication;
2. to compare the patient adherence and adverse effects of these treatment regimens;
3. to investigate factors that may influence H. pylori eradication by these treatment
regimens.
Participants, aged ≥ 20, having H. pylori-positive chronic gastritis with/without peptic
ulcers (duodenal or gastric ulcers) will be recruited. All undergo endoscopy with biopsy for
rapid urease teat, histology, and bacterial culture before treatment. Four to eight weeks
after termination of treatment, H. pylori infection status will be examined by the 13C-urea
breath test. The CYP2C19 genotype of each participant will be analyzed by the polymerase
chain reaction-based restriction fragment length polymerase (PCR-RFLP) method. A computed
generated random numbers sequence will be blocked into two subgroups, say A, and B.
If the patients failed anti-H. pylori therapy previously, they will be invited to enter this
study for evaluating the efficacy of these rescue regimens. Participant who meet the
inclusion criteria and do not have any one of the exclusion criteria will be randomized to
receive one of the following regimens:
group A- HDDT (rabeprazole 20 mg qid + amoxicillin 750 mg qid for 14 days);
group B- BQT ( rabeprazole 20 mg qid + tripotassium dicitrate bismuthate 300 mg qid +
metronidazole 250 mg qid + tetracycline 500 mg qid for 10 days);
All participants will be asked to complete a questionnaire and to record symptoms and drug
consumption daily during the treatment period. Post-treatment, the participants will be
followed up at the Outpatients Clinic to investigate patient adherence and adverse effect of
treatment.
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