EVALUATION OF TRIPLE AND QUADRUPLE REGIMENS IN ERADICATION OF HELICOBACTER PYLORI INFECTION IN PEDIATRIC PATIENTS IN EMAM KHOMEINI HOSPITAL IN 2002-2003: A RANDONUZEDCL�CAL TRlAL

Background: Triple therapy with a proton pump inhibitor, c1arithromycin and amoxicillin and quadruple therapy with a proton pump inhibitor, bismuth citrate, met­ ronidazole and amoxicillin have been proposed in Maastricht 2000 as the optimal treat­ ment of Helicobacter pylori infection. We aimed to compare these two regimens in Iranian pediatric patients. Methods: A randomized clinical trial in Emam Khomeini Hospital between 1381 and 1382 was done. Patients with confirmed H. pylori infection by histology were divided in to two groups in a randomized 1: 1 scheme. Triple regimen group: Clarithromycin 15 n1g/kg/d, Amoxicillin 50 n1g1kg/d and Omeprazole 1 mg/kg/day for 10 days . . Quadruple regimen group: Omeprazole Img/kg/d, Amoxicillin 50 mg/kg/day, Met­ ronidazole 20 mg/kg/day and Bismuth citrate 8 mg/kg for 10 days. The eradication was assessed by c-urea breath test 4 weeks after the end of treatment and by perprotocol analysis. Results: In our study, 1 00 pati�nts (50 in each group) were found and the eradi­ cation rates in the triple and quadruple group were 92% and 84% respectively (p=0.046). Conclusion: According to our results, we recommend triple therapy as first-line treatment in Iranian pediatric patients and quadruple therapy as a second line regimen. MJIRI, Vol. 19, No. 1, 29-33, 2005.