Background: A high-dose proton pump inhibitor (PPI)-amoxicillin dual therapy has been investigated for treatment of patients with () infection. Currently, the efficacy of this dual therapy remains inconclusive, with controversial findings from various single-center clinical trials.
Objectives: To assess the efficacy and safety of high-dose dual therapy (HDDT) compared with the bismuth-containing quadruple therapy (BQT) in treatment-naive patients with infection.
Design: A multicenter, open-label, randomized controlled clinical trial.
Methods: Three hundred and forty treatment-naïve patients with infection were prospectively recruited from seven participating hospitals. The enrolled patients were randomized into one of two treatment groups: the HDDT group (esomeprazole, 20 mg four times daily; amoxicillin, 750 mg four times daily) and the BQT group (esomeprazole, 20 mg, twice daily; bismuth potassium citrate, 600 mg, twice daily; amoxicillin, 1 g, twice daily; metronidazole, 400 mg, four times daily). The primary outcome was eradication rate, and secondary outcomes were safety and patient compliance.
Results: The eradication rates in the HDDT group the BQT group were 86.47% 87.06% on intention-to-treat (ITT) analysis, 91.88% 92.50% on modified ITT (MITT) analysis, and 91.77% 93.04% on per-protocol (PP) analysis, with no significant differences between the two groups. The patient compliance rates in the HDDT group the BQT group were 97.02% 95.86%, and no significant difference was found between the two groups. Notably, the HDDT group exhibited significantly lower incidence in the drug-induced adverse events (AEs) compared to the BQT group (16.67% 47.94%).
Conclusion: HDDT is equally efficacious in eradicating infection and resulted in good patient compliance and safety compared with BQT. These findings provide evidence in support of HDDT as a first-line treatment for infection.
Registration: This clinical trial was registered at The Chinese Clinical Trial Registry (trial registration number: ChiCTR2000039096).
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| http://dx.doi.org/10.1177/17562848221142925 | DOI Listing |
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