One-Week PPI Triple Therapy As First-Line H.pylori Eradication Regime In Malaysia- Still An Effective Regimen?

Background:
One-week triple therapy for Helicobacter pylori (H.pylori) eradication comprising a proton-pump inhibitor(PPI), amoxicillin and clarithromycin have continued to show high eradication rates in our experience even in recent times.
Objective:
To re-examine the efficacy and tolerability of 1-week proton pump inhibitor triple therapy as a first-line H.pylori eradication therapy.
Methods:
Consecutive treatment naïve participants with a positive rapid urease test during an outpatient upper endoscopy were included. All participants were given rabeprazole(Pariet) 20mg b.i.d., amoxicillin(Ospamox) 1g b.i.d. and clarithromycin(Klacid) 500mg b.i.d. for 1 week. Successful eradication was defined by negative 13C-urea breath test or rapid urease test through upper endoscopy at least 4 weeks after the completion of therapy.
Results:
A total of 112 patients have been recruited thus far in this on-going study. Per-protocol and intention-to-treat eradication rates were 88.8%(95/107)(95% CI: 81.7-93.8%) and 84.8%(95/112)(95% CI: 77.3-90.6%) respectively. Overall 69 participants (61.6%) reported no side effects, followed by 23(20.5%) with bitter taste, 16(14.3%) had epigastric pain, 12(10.7%) had diarhoea during treatment, 9(8.0%) had nausea, 7(6.3%) had vomiting, 6(5.4%) had loss of appetite, 4(3.6%) had dizziness and headache and 2(1.8%) had rashes and diarrhoea after treatment. All side effects were considered mild.
Conclusion:
The 1-week H.pylori triple therapy is still an effective 1st line eradication regime. We await larger sample population to confirm our findings.