Quantiple (5 drugs) regimen for H.pylori radication in quadruple non-responder dyspeptic patients
Introduction: Helicobacter pylori (HP) infection is a common infection in developing countries. There are multiple regimens for the eradication of this infection but antibiotic resistance is increasing. The aim of this study is determination of HP eradication rate after 7-days quntiple therapy in quadruple non-responder dyspeptic patients. Method: This interventional study was performed at 2010-2011 in Rasht Razi hospital. Patient’s age were 15-65 years. They were treated with a 2-weeks quadruple therapy, previously and were still HP positive. A seven-day course of quntiple therapy with Amoxicillin(1g/BD), Tinidazole (500mg/BD), Clarithromycin(500mg/BD), Omeprazole 20mg/BD) and Bismuth Subcitrate (240 mg/BD) was started. Twelve weeks after the end of treatment, a C13-UBT test together with HP stool Ag was performed. Eradication was considered successful if the results of both tests were negative. Chi-square test was used for statistical analysis A P-Value less than 0.05 was considered significant. Results: Out of 97, 35 patients had been excluded due to intolerance to therapentic regimen. The eradication rates were 82.3% and 52.5% by per-protocol & Intention-to-treat analysis, respectively. There was no significant relation between HPeradication rate and, age, gender, smoking and the presence of cag-A Antigen. Conclusion: Despite acceptable eradication rate by this regimen, significant intolerance and side-effects were the most important limitation of this regimen.