High-dose Proton Pump Inhibitor Versus Standard-dose Proton Pump Inhibitor in PPI-based Triple Therapy for Helicobacter pylori Eradication in Lampang Hospital: A randomized Controlled Trial

OBJECTIVE The study aimed to compare the eradication rates with high-dose proton pump inhibitor (PPI) and standard-dose PPI in PPI-based triple ther-apy as first-line treatment for H. pylori eradication.METHODS This prospective, open label, randomized controlled trial. A total of 150 patients infected with H. pylori diagnosed by rapid urease test were randomly assigned to one of 2 groups. The first group was treated with standard dose PPI-based triple therapy (omeprazole 20 mg bid, amoxicillin 1000 mg bid, and clarithromycin 500 mg bid) for 14 days and the second with high dose PPI-based triple therapy (omeprazole 40 mg bid, amoxicillin 1,000 mg bid, and clarithromycin 500 mg bid) also for 14 days. H. pylori eradication was evaluated using a urea breath test. Patient compliance and side effects were also recorded.RESULTS In all, 75 patients were assigned each group. The H. pylori eradica-tion rate in the high-dose PPI based triple therapy group was 92% by inten-tion-to-treat (ITT) analysis and 93.05% by per-protocol (PP) analysis, com-pared with the standard-dose PPI based triple therapy group values of 84% and 85.92% (p < 0.001 and 0.032), respectively. Side effects were mild in both groups with no significant differences between groups.CONCLUSIONS High-dose PPI based triple therapy provides a higher eradica-tion rate of H. pylori infection than standard-dose PPI based triple therapy for first-line treatment with no difference in side effects.