n South African Medical Journal - eradication : a randomised comparative trial of 7-day versus 14-day triple therapy : research




is associated with several upper gastrointestinal conditions including chronic gastritis, peptic ulcer disease, and gastric malignancy. Proton pump inhibitor-based triple therapies are considered the standard regimens for eradication, but the optimal duration of therapy is controversial. To prevent infection and complications, local studies should be undertaken to evaluate eradication rates in a country.

We compared 7-day and 14-day regimens to determine the optimum duration of triple therapy for eradication.
We undertook a prospective randomised comparative trial of 7-day and 14-day triple therapy regimen for eradication at the Aga Khan University Hospital, Nairobi; 120 patients with dyspepsia and infection were randomised to receive esomeprazole, amoxicillin and clarithromycin for either 7 days (EAC 7) or 14 days (EAC 14). Compliance and side-effects were assessed 2 weeks after the start of therapy and eradication was assessed by stool antigen tests 4 weeks after treatment.
Both the intention-to-treat (ITT; N=120) and per protocol (PP; N=97) analyses showed no significant differences between the eradication rates of EAC 7 (ITT 76.7%; PP 92%) and EAC 14 (ITT 73.3%; PP 93.6%) (ITT =0.67; PP =0.76). Poor compliance was reported in one patient in the EAC 14 group. The incidence of adverse events was comparable in the two groups.
One-week and 2-week triple treatments for eradication are similar in terms of efficacy, safety and patient compliance.


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