Comparing the Efficacy of Standard Triple Therapy with Proton Pump Inhibitor and Vonoprazan and Amoxicillin Dual Therapy for Helicobacter Pylori Eradication

Abstract

Objective: To compare the effectiveness of dual therapy with amoxicillin plus vonoprazan and standard triple therapy with amoxicillin, clarithromycin and proton pump inhibitor in terms of H Pylori eradication.

Study Design: Randomized controlled trial study

Place and Duration of Study: This study was conducted at the Department of gastroenterology in Bakhtawar Amin Medical & Dental College, Multan, from October 2021 to September 2022.

Materials and Methods: A total of 84 patients diagnosed as positive for Helicobacter Pylori infection through stool antigen test. Grouping of patients was done by lottery method in group A and B. In group A Vonoprazan and amoxicillin was given and in group B Amoxicillin with clarithromycin and proton pump inhibitor (PPI) were given. Main variables of study were Stool antigen (positive/negative), Bloating, diarrhea and nausea vomiting. SPSS version 24 was used for data analysis.

Results: The average age of Group A and Group B was 39.12±3.22 years and 38.51±2.84 years respectively. Male proportion is higher in both groups. In Group A, 71.4% patients had negative HP stool Ag and 59.5% patients had negative HP stool Ag, in Group B. (p>0.050). The prevalence of diarrhea, nausea vomiting and bloating in both the groups were 14.3% vs. 9.5%, 16.7% vs. 14.3% and 16.7% vs. 2.4 respectively (p>0.050).

Conclusion: Vonoprazan and amoxicillin dual therapy is better as compare to conventional triple therapy for h pylori eradication. In this era of rapidly developing antibiotic resistance, use of Vonoprazan based dual therapy for h pylori eradication is potentially new 1^st line treatment.