Potassium competitive acid blocker based sequential therapy in treatment of naïve and previously treated patients with H. pylori infection

Document Type : Original Article

Authors

1 Tropical Medicine Department, Faculty of Medicine, Menoufia University, Shebin El- Kom, Egypt

2 Public Health and Community medicine department, Faculty of Medicine, Menoufia university, Egypt

3 Clinical Pathology department, Faculty of Medicine, Menoufia university, Egypt

4 Internal Medicine Department, Gastroentrology Unit, Faculty of Medicine, Alexandria university, Egypt

5 Hepatology and Gastroenterology Department, National Liver Institute, Menoufia university, Shebin El- Kom, 32511, Egypt

Abstract

Background: Helicobacter pylori (H. pylori) colonize the gastric lining and cause gastrointestinal disorders. Treatment of H. pylori has developed lately to improve eradication rates. Our objective was to evaluate potassium competitive acid blocker based sequential therapy in treatment of naïve and previously treated patients with H-pylori infection. Methods: Prospective cohort study included 180 patients diagnosed with H. pylori infection either naïve or previously treated were divided into 4 groups. Group I included naïve patients received traditional therapy (PPI 40 mg once daily, clarithromycin500mg twice daily & metronidazole 500mg twice daily)for 14days, group II included naïve patients on P-CAB based sequential (5 days of vonaprazan 20mg twice daily, moxifloxacin 400 mg  once daily, nitazoxanide 500 mg twice daily,  followed by 5 days of vonaprazan 20mg twice daily, levofloxacin 500mg once daily & metronidazole 500mg twice daily), group III included previously failed treatment patients received P-CAB based sequential, and group IV included previously treated  patients on LOAD therapy(10 days of omeprazole 40mg once daily, levofloxacin 500mg once daily, nitazoxanide 500mg twice daily, & doxycycline 100mg twice daily). H.‎pylori stool antigen test done at the time of diagnosis and after 4- 6 weeks after end of treatment.‎ Results: The cure rate among the studied groups was higher in GII (93.3%) followed by GIII (88.9%), then GIV (71.1%) and the least response is GI (62.2%). Conclusion: P-CAB based sequential regimen was the highest eradication rate and least side effects in comparison with traditional and LOAD therapy.

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