Background:
Recommended proton pump inhibitor (PPI)-clarithromycin-amoxicillin or metronidazole treatment
for 7 to14 days is the first choice treatment for H pylori infection. The eradication rate of
the standard triple therapy has generally declined to unacceptable levels (i.e., 80% or less)
recently because the increasing incidence of clarithromycin-resistant strains of H. pylori.
Standard triple therapies should be abandoned in the areas with clarithromycin resistance ≥
20%. The investigators have proven that 7-day Concomitant therapy can achieve a promising
success rate of >90 % in the presence of clarithromycin resistance. However, high dose PPI is
needed with a dosage of twice daily but when a dual delayed release formulation PPI in
capsules for oral administration (Dexlansoprazole MR), a once daily dose may be needed only.
The capsules contain dexlansoprazole in a mixture of two types of enteric-coated granules
with different pH-dependent dissolution profiles. It suppresses gastric acid secretion via
inhibition of the proton pump in the gastric parietal cell, which blocks the final step of
acid production. Thus, it improves acid suppression and offer benefits over conventional
single release PPI formulations. by prolonging optimal plasma concentration and create a
favorable condition H. pylori eradication
Aim:
The efficacy of Dexlansoprazole MR-based concomitant quadruple therapy