Background: Helicobacter pylori (H. pylori) is a human gastrointestinal pathogen that infects more than half of the world's population and leads to chronic gastritis and its role in the development of gastric ulcers, gastric cancer and gastric lymphomas is considered. However, eradication of this bacterium with triple therapy fails in more than 30% of cases. Therefore, efforts to find new treatment methods are increasing. As a result, this study was conducted to evaluate the effectiveness and tolerability of several drug regimens compared to the standard regimen.
Methods: This study is a randomized clinical trial in which patients with Helicobacter pylori infection were randomly selected in the endoscopy department of Amiralmomenin Hospital and the Gastroenterology Clinic of Professor Ghavamzadeh Clinic, Arak from October 2024 to March 2025 and were divided into three groups, including a control group and two intervention groups, with three different drug regimens. Four weeks after treatment, the rate of bacterial eradication in all three evaluation groups was assessed using fecal antigen testing and the treatment results were compared using appropriate statistical analyses.
Results: The frequency of negative test results in intervention group 2 was higher than in control and intervention group 1. (P<0.001) and the rate of Helicobacter pylori eradication was in intervention group 2 (94%), in control group (54%), and in intervention group 1 (20%). The chance of H.P eradication in intervention group 1 decreased by 84% compared to the control group and increased by 10.77 times in intervention group 2 compared to the control group. Also, a significant proportion of H.P eradication success was observed in people without diabetes (p-value = 0.022, Phi = -0.188, n = 150) and the rate of drug side effects was higher in intervention group 2 compared to the other two groups.
Conclusion: This study showed that compared to the standard regimen, a 2-week regimen of amoxicillin, omeprazole, and clarithromycin plus bismuth is a good, potent, and more cost-effective regimen for eradicating Helicobacter pylori.
