Comparison of the Success Rate of Quadruple and Triple Antibiotic Therapy in Eradicating Helicobacter pylori Infection in Southwest of Iran: A Randomized Clinical Trial

[Background]Helicobacter pylori (H. pylori) bacterium has contaminated over 80% of the population of developing countries. H. pylori has a major role in developing gastric ulcer, duodenal ulcer, chronic gastritis, as well as gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma (MALT). To eradicate H. pylori infection, information about regional antibiotic resistance is necessary. Therefore, this study was conducted to compare the success rate of quadruple and triple antibiotic therapy in eradicating H. pylori infection in southwest of Iran (Yasuj).[Methods]This was a randomized clinical trial, in which 60 patients aged 15 to 80 years, who referred with dyspepsia and peptic ulcer symptoms to the outpatient clinic of Shahid Mofatteh, Yasuj, Iran, in 2014, enrolled after confirmation of H. pylori infection. All participants provided written informed consent. Then, they were randomly allocated to quadruple (amoxicillin, metronidazole, bismuth subcitrate, and pantoprazole) and triple (amoxicillin, clarithromycin, and pantoprazole) antibiotic therapy regimens for 2 weeks. H. pylori stool antigen test was performed for all patients 6 weeks after the end of the treatment. SPSS17 software was used for data analysis.[Results]From 60 patients, 29 (48.3%) and 31 (51.7%) received quadruple and triple antibiotic therapy regimens, respectively. H. pylori stool antigen test was negative in 23 (79.3%) and 16 (51.6%) treated patients with quadruple and triple antibiotic therapy regimens, respectively (P = 0.023).[Conclusions]The success rate of quadruple therapy was considerably higher than triple antibiotic therapy, and this might be due to clarithromycin resistance.