Comparison of half-dose and full-dose triple therapy regimens for Helicobacter pylori eradication in patients with end-stage renal disease

ABSTRACT

The aim of this study was to compare the half-dose and full-dose triple therapy regimens for Helicobacter pylori [Hp] eradication in patients with end-stage renal disease. H. Pylori is one the most important causes of dyspepsia in patients with end-stage renal disease [ESRD]. Sixty-six patients with ESRD were enrolled in the study with Hp infection and peptic disease with a need of Hperadication. Patients were randomly assigned to full-dose [A=35 patients] or half-dose group [B=31 patients]. Patients received clarithromycin 500 mg, amoxicillin 1000 mg and omeprazole 20 mg twice daily in group A and clarithromycin 250 mg and amoxicillin 500 mg twice daily and omeprazole 20 mg once daily in group B for two weeks. Patients provided stool samples 4 weeks of completing study to assess the success of Hp eradication by Hp-specific stool antigen. Finally, the rate of eradication and complications were compared between two groups. The successful Hp eradication was achieved in 26 patients [74%] in group A and in 22 patients [74%] in group B. The difference between 2 groups was not statistically significant [p=0.973] [per protocol analysis]. Half-dose triple-therapy with clarithromycin, amoxicillin and omeprazole is as effective as full-dose triple-therapy to eradicate the Hp in patients with ESRD. According to lower toxicity level, complications and cost in half-dose regimen in this subset of patients, this protocol is advised