Comparison of half-dose and full-dose triple therapy regimens for Helicobacter pylori eradication in patients with end-stage renal disease

The aim of this study was to compare the half-dose and full-dose triple therapy regimens for Helicobacter pylori (Hp) eradication in patients with end-stage renal disease. H. Pylori is one the most important causes of dyspepsia in patients with end-stage renal disease (ESRD).Patients and Sixty-six patients with ESRD were enrolled in the study with Hp infection and peptic disease with a need of Hp eradication. Patients were randomly assigned to full-dose (A=35 patients) or half-dose group (B=31 patients). Patients received clarithromycin 500 mg, amoxicillin 1000 mg and omeprazole 20 mg twice daily in group A and clarithromycin 250 mg and amoxicillin 500 mg twice daily and omeprazole 20 mg once daily in group B for two weeks. Patients provided stool samples 4 weeks of completing study to assess the success of Hp eradication by Hpspecificstool antigen. Finally, the rate of eradication and complications were compared between two groups. The successful Hp eradication was achieved in 26 patients (74%) in group A and in 22 patients (74%) in group B. The difference between 2 groups was not statistically significant (p=0.973) (per protocol analysis). Half-dose triple-therapy with clarithromycin, amoxicillin and omeprazole is as effective as full-dose tripletherapy to eradicate the Hp in patients with ESRD. According to lower toxicity level, complications and cost in halfdose regimen in this subset of patients, this protocol is advised.