Publication:

The impact of bismuth adding to rabeprazole, amoxicillin and clarithromycin on eradication rate of Helicobacter pylori

Background High prevalence of Helicobacter pylori infection and induction of resistance as a result of consumption of antibiotics necessitates an ongoing effort for evaluation of new regimen to overcome this phenomenon.  Intensive efforts are being made to identify such an optimal regimen, but there are many obstacles hindering the achievement of this goal. This study aimed to investigate the impact of adding bismuth to rabeprazole, amoxicillin and clarithromycin on rate of H. pylori eradication.

Methods In this randomized clinical trial, 60 patients with dyspepsia and positive gastric biopsy for H. pylori in endoscopy were recruited. The first group (A) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either with bismuth for 2 weeks and the second group (B) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either without bismuth. Four weeks after the treatment, the compliance and eradication were evaluated using stool antigen of helicobacter. The patients who could complete the therapeutic regimen were assigned for analysis.

Results H. pylori eradication rates were 70% and 56.6% in two groups A and B (with and without Bismuth), respectively and the difference was significant. There is a significant relationship between the studied groups and the results of fecal antigen of H. pylori.

Conclusions The bismuth had a significant effect on the success of eradication rate of H. pylori and its impact adding to the treatment regimen containing clarithromycin was effective on eradication success rate.