Is It More Effective to Prescribe a Proton Pump Inhibitor Separately before a Meal for the Eradication of Helicobacter pylori ?

Abstract

Background and Aim: The current standard regimen for treatment of Helicobacter pylori (H. pylori) is a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. The aim of this study was to determine the effectiveness of prescribing PPIs before a meal separately for treatment of H. pylori. Methods: Between January 2008 and December 2012, a total of 160 patients who tested positive for rapid urease in our hospital were reviewed retrospectively. We divided these patients into two groups according to the administration method of triple therapy for the eradication of H. pylori. One group of people took all three medicines at once after a meal (group A). Another group of people took a PPI before a meal and took amoxicillin and clarithromycin after a meal (group B). After 4 weeks, a 13C-urea breath test was performed to validate eradication of H. pylori. Results: The eradication rate of group A was 72.5% (58/80) and the eradication rate of group B was 75% (60/80). There was no significant difference between the two groups (p = 0.719). Some patients in both groups experienced adverse effects. Specifically, four out of 80 patients (5%) in group A and 6 out of 80 patients (7.5%) in group B reported adverse events. There was also no significant difference between the groups in the occurrence of adverse effects (p = 0.232). Conclusion: To recommend administration of all medicines at once after a meal may be the better prescription, considering the convenience to the patient and improved likelihood of compliance.