[Comparison of sequential and routine four drugs therapeutic regiments in Helicobacter pylori eradication]

Antibiotical resistance to Helicobacter pylori reduced the eradication rates. This study was done to compare the sequential comparison of sequential and routine four drugs therapeutic regiments in Helicobacter pylori eradication. In this double blind clinical trial study 160 chronic dyspepsia patients randomly divided into 2 groups of sequential and routine four drugs therapeutic regiments. We performed invasive tests for H. pylori in patients who underwent gastroduodenoscopy. 160 patients who were diagnosed as H.pylori-positive by histological evaluation were selected for the trial. A 14-day sequential regimen [Omeprazole, Amoxicillin, each administered twice daily for the first 5 days, followed by Omprazole, Clarithromycin and Urazolidon, each administered twice daily for the remaining 9 days. 14-day 4 drug therapy, Omprazole, Clarithromycin, Amoxicillin and Bismoot each administered twice daily. 5 weeks after treatment urease breath test [UBT] was preformed. The recovery was seen in 50.9% and 49.1% in sequential and routine four drugs therapeutical treatment, respectively. The recovery of patient with severe H. pylori infection was non-significantly higher in sequential regiment [64.7%] than four drugs regiment [41.2%]. In comparison to four drugs, sequential therapy was significantly more effective in patients with sever gastritis [87.5% vs. 25%, p<0.05]. The eradication of H. pylori infection particularly in severe gastritis is preferred by sequential therapeutical regiment

[Comparison of anti-H.pylori therapeutic responses in two groups of patients with and without cagA Ab]

CagA antigen is found in 60-80% of Helicobacter Pylori organisms. It seems that CagA positive strains have more virulence. The aim of this study was to compare the eradication rate of CagA positive and CagA negative genotypes using current quadruple regimens. The patients who had positive results for Helicobacter Pylori after endoscopy in Hazrat-Rasool Hospital were enrolled into the study. In 56 patients with positive rapid urease test [RUT], Anti CagA was determined and a 2-week quadruple regimen [Omeprazole, Amoxicillin, Metronidazole, and Bismuth] was prescribed. The UBT was performed two months after the end of treatment. Of 56 patients who were infected with Helicobacter Pylori, 36 [64.3%] had CagA antibody. 15 [26.8%] patients had positive UBT and 41 [73.2%] patients had negative tests. The success rate of treatment was 69.44% [25 patients] in CagA positive and 80% [16 Patients] in CagA negative participants. This difference was not statistically significant [P=0.533]. The presence of CagA is associated with higher success rate in conventional triple regimens but sufficient data for quadruple therapeutic regimens are not available. We did not find any association between CagA positivity and eradication rate of H.pylori