Intraluminal Therapy for Helicobacter Pylori Infection
Status:
Completed
Trial end date:
2018-04-30
Target enrollment:
Participant gender:
Summary
Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in humans.
The prevalence of H. pylori is about 30~50% in the Western adult population. It is estimated
that about 50% of people are infected with this bacterium in Taiwan. Many studies have shown
that H. pylori is an important causal factor of chronic gastritis, peptic ulcer disease,
gastric cancer and gastric lymphoma. The World Health Organization classified H. pylori as a
Group 1 carcinogen in 1994. Endoscopic examination is indicated to confirm the above
diagnosis for patient with H. pylori infection. Eradication of H. pylori infection reduces
the risk of gastric cancer and recurrence of peptic ulcer disease. However, the eradication
rate of clarithromycin-based triple therapy has been declining in recent years, probably
related to the increasing resistant rate to clarithromycin. Several strategies have been
proposed to overcome the declining eradication rate, including (1) extending the treatment
duration of triple therapy to 14 days; (2) the use of bismuth quadruple therapy which
contains bismuth, a proton pump inhibitor, and two antibiotics (usually metronidazole and
tetracycline); (3) non-bismuth quadruple therapy (concomitant therapy) which contains a
proton pump inhibitor and three antibiotics (usually amoxicillin, metronidazole, and
clarithromycin); (4) sequential therapy which contains a proton pump inhibitor (PPI) plus
amoxicillin for five days, followed by a PPI plus clarithromycin and tinidazole for another
five days. The investigators aim to improve the eradication rate of H. pylori infection while
an endoscopic examination is performed.