Effectiveness of Triple Therapy Regimens in the Eradication of Helicobacter pylori in Patients with Uninvestigated Dyspepsia in Ekiti State, Nigeria

Aim and Objective: The term dyspepsia has been used inconsistently by healthcare professionals to describe different patterns of upper gastrointestinal symptoms. It denotes a symptom and does not itself represent a disease. In this study, we seek to determine the effectiveness of common triple therapy regimens in use in the eradication of H. pylori in this environment and to compare it what is obtained worldwide.
Materials and Methods: One hundred and four Consecutive adult patients, aged 18 to 50 years presenting newly with uninvestigated dyspepsia and without alarm symptoms at General Outpatient Clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti and the Federal Medical Centre, Ido-Ekiti, Nigeria were randomized into five treatment groups in the study. Approval was obtained from Ethical Committees of the two study centres. Treatment outcome was computed using frequency table.
Results: The mean age of the studied population was 37.8±12.98 years. 32.7% were males while 67.3% were females. Most prevalent symptom for uninvestigated dyspepsia was abdominal discomfort 100 (96.2%), this was followed by early satiety, abdominal fullness and vomiting with 32 (30.8%), 26 (25%) and 13 (12.5%) of the participants respectively. 76.0% were positive for H. pylori infection by Urea Breath Test Heliprobe® System with highest prevalence of H. Pylori infection within age group 31-45 years (36.7%).
Rabeprazole-Clarithromycin-Metronidazole group (RCM) had the highest eradication rate per protocol [77.8%], followed in descending order by Rabeprazole-Amoxil- Levofloxacin group (RAL) [53.3%], Omeprazole-Tinidazole-Clarithromycin “ulcer kit” (OTC) [44.4%], Rabeprazole-Amoxil-Metronidazole group (RAM) [44.4%] and Rabeprazole-Amoxil-Clarithromycin (RAC) [30.0%].
Conclusion: This study showed there is difference in eradication rates of popularly known triple therapy regimens. This may be due to geographical differences in antibiotics resistant pattern to H. pylori. Further study is suggested to find out the national sensitivity pattern to the commonly used triple therapy regimens in Nigeria.