Evaluation of triple and quadruple regimens in eradication of helicobacterpylori infection in pediatric patients inEmam Khomeini hospital in 2002-2003: a randomized clinical trial

ABSTRACT

Triple therapy with a proton pump inhibitor, clarithromycin and amoxicillin and quadruple therapy with a proton pump inhibitor, bismuth citrate, metronidazole and amoxicillin have been proposed in Maastricht 2000 as the optimal treatment of Helicobacterpylori infection. We aimed to compare these two regimens in Iranian pediatric patients.Arandomized clinical trial in Emam Khomeini Hospital between 1381 and 1382 was done. Patients with confirmed H. pylori infection by histology were divided in to two groups in a randomized 11 scheme.Triple regimen group Clarithromycin 15 mg/kg/d, Amoxicillin 50 mg/kg/d and Omeprazole 1 mg/kg/day for 10 days.Quadruple regimen group Omeprazole 1 mg/kg/d, Amoxicillin 50 mg/kg/day, Met-ronidazole 20 mg/kg/day and Bismuth citrate 8 mg/kg for 10 days. The eradication was assessed by c-urea breath test 4 weeks after the end of treatment and by perprotocol analysis.In our study, 100 patients [50 in each group] were found and the eradication rates in the triple and quadruple group were 92% and 84% respectively [p= 0.046].According to our results, we recommend triple therapy as first-line treatment in Iranian pediatric patients and quadruple therapy as a second line regimen