Muhammad Tauqeer, Mir Tahir Hussain Talpur, Toufique Ahmed, Nasrullah Aamer, Kashifullah Shabir, Uzair Yaqoob.
Efficacy of triple regimen therapy for H. pylori eradication with and without azithromycin.
Pak J Surg Jan ;36(2):152-6.

Objective: To compare the efficacy of triple therapies for H. pylori eradication with versus without azithromycin in patients with active duodenal ulcer. Material and Methods: This clinical trial was conducted at Medical ICU of Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan from December 2013 to June 2014. A total of 60-patients of either gender with age >=18 years presenting with active duodenal ulcer and confirmed H. Pylori infection with >3 months symptom duration were included. 30-patients were assigned to each of the two groups through opaque envelope randomization method. Group-A was prescribed azithromycin, 1g OD, for first 3 days (total dose 3 g), amoxicillin, 1g bid and omeprazole, 20 mg, bid (OAA regimen). Group-B received metronidazole, 500 mg bid, amoxicillin, 1g bid and omeprazole, 20 mg bid (OAM regimen). Both above regimens were given for 1-week, followed by monotherapy of omeprazole, 20 mg, OD, in both groups for 3-weeks. At the end of the 8th week, endoscopy and urea breath test were repeated to confirm H. pylori eradication. Results: Both groups were comparable regarding basic demographic characteristics. Mean age of patients in group-A and group-B was 44.06+-8.70 and 43.65+-8.55 years, respectively. Mean duration of symptoms of patients was 5.91+-1.36 months in group-A and 5.72+-1.52 months in group-B. It was found that efficacy of OAA triple therapy in H. pylori eradication was 63.3% compared to that of OAM, which was 26.7%. The difference was statistically significant (p value= 0.004). Age, gender and duration of symptoms were significant effect modifiers. Conclusion: The efficacy of triple therapy containing azithromycin in H. pylori eradication was significantly higher compared to traditional triple therapy in patients with active duodenal ulcer in our setting.

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