Eradication of Helicobacter pylori in Jordan, Middle East is it different? A quasi experimental study
Abstract
BACKGROUND AND STUDY AIMS
Helicobacter pylori is a major cause of peptic ulcer disease and is strongly associated with gastric cancer. Rising resistance to Clarithromycin-based regimens has led to evaluation of alternative therapies, including Levofloxacin-based combinations. This study aimed to compare the efficacy of Clarithromycin- versus Levofloxacin-containing triple therapy in a Jordanian population, and to assess the impact of diagnostic methods and metronidazole use on treatment outcomes.
PATIENTS AND METHODS
In this prospective, non-randomized controlled trial, 364 adults with confirmed H. pylori infection were recruited from two governmental hospitals in Jordan. Patients received either Clarithromycin- or Levofloxacin-based triple therapy, with or without metronidazole. Diagnosis and treatment response were assessed using gastric biopsy, rapid urease test, or stool antigen test. Follow-up testing occurred four weeks post-treatment. Chi-square tests and Cramer's V were used for statistical analysis.
RESULTS
The overall eradication rate was 65.1 %. Clarithromycin-based therapy showed a higher eradication rate (70.8 %) than Levofloxacin-based therapy (60.2 %), though the difference was not statistically significant (P = 0.64). Among patients diagnosed via stool antigen testing, Clarithromycin therapy was significantly more effective (66.3 % vs. 40.4 %, P = 0.003). Neither metronidazole addition nor type of proton pump inhibitor influenced eradication outcomes.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 364 participants or records.
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