INCREASING RATES OF TREATMENT FAILURES WITH THE STANDARD TRIPLE THERAPY FOR HELICOBACTER PYLORI: A UNIQUE AND ALTERNATIVE TREATMENT OPTION IS URGENT

Background: The triple treatment including Proton pump inhibitor (PPI) - clarithromycin and amoxicillin or metronidazole was proposed 30 years ago at the first Maastricht conference to treat helicobacter pylori (H. pylori) infection and since that time, it has become the u niversal and standard treatment for helicobacter pylori. However, the efficacy of this triple regimen has been seriously challenged, and they are gradually becoming ineffective. Aim: to assess the response of patients with H. pylori to the standard triple therapy in Nile delta. Patients and Methods: Patients who visited the outpatient clinics in tropical medicine department Tanta university hospital between January 2012 and June 2015 complaining of dyspepsia were tested for H. Pylori and H. pylori infected patients received first - line eradication therapies with standard triple regimens (PPI twice/day, 500 mg of clarithromycin twice/day and 1 g of amoxicillin twice/day or 500 mg metronidazole twice/day for two weeks). 6 weeks after completion of therapy, erad ication of H. pylori infection was assessed using stool helicobacter pylori antigen. Results: one thousand and ninety patients infected with helicobacter pylori received the standard triple therapy. Eradication rates were 59.36% and 62.03% according to an intention - to - treat and per - protocol analysis, respectively raising questions if H. Pylori is still responding to standard triple therapy. Conclusions: There is growing rates of treatment failure with standard triple therapy. The efficacy of standard eradication therapies is expected to further decrease in the next years. So, development of unique and alternative treatment regimens with high eradication rates is urgent.