Indian Journal of Gastroenterology

, Volume 37, Issue 6, pp 550–554 | Cite as

Comparison between  daily single-dose triple therapy and conventional triple therapy on patient compliance and Helicobacter pylori eradication: A randomized controlled  trial

  • Shaahin ShahbaziEmail author
  • Zahra Vahdat Shariatpanahi
Original Article



The poor compliance to treatment of Helicobacter pylori-infected patients is well-known. We evaluated the efficacy of daily single-dose triple therapy as compared to conventional triple therapy on patient compliance and eradication of H. pylori infection.


In the study group, 105 patients received esomeprazole 40 mg, tinidazole 1 g, and levofloxacin 500 mg once-daily for 14 days. One hundred and seven patients in the control group received lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice-daily for 14 days. Four weeks after completing therapy, urea breath test was performed to assess the eradication of H. pylori infection.


The eradication rates by intention-to-treat analysis were 86% and 90.2% and by per-protocol analyses were 90.5% and 95.3% in the control and study groups, respectively, with no significant differences. Drug compliance was significantly better in the study group compared to the control group (p = 0.04). Overall, 44.7% of the patients in the study and 47.6% in the control groups had at least one adverse event. The most common adverse event was the dysgeusia in both the groups. The occurrence of diarrhea, nausea and vomiting was significantly higher in the control group and that of arthralgia was higher in the study group. The presence of periodontal disease and drug compliance was independently associated with treatment failure.


The use of single-dose PPI-based triple therapy improves drug compliance and eradication rate to standard PPI-based triple therapy. Presence of periodontal disease and drug compliance had negative influence on the eradication rate.

Trial Registration



Esomeprazole PPI-based triple therapy Urea breath test 



We convey our gratitude to the Ilam University of Medical Sciences, Ilam, Iran, and the staff of Mostafa Khomeini Hospital.

Author contributions

Z. V. and S. S. equally contributed to the conception/design of the research; S. S. contributed to the acquisition of the data; Z. V. contributed to the analysis and interpretation of the data. The authors drafted and critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Compliance with ethical standards

The study protocol was approved by the Institutional Ethics Committee.

Conflict of interest

SS and ZVS declare that they have no conflict of interest.

Ethical approval

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on


The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/ findings and content of this article.


  1. 1.
    O’Connor A, Gisbert J, McNamara D, O’Morain C. Treatment of Helicobacter pylori infection. Helicobacter. 2010;15:46–52.CrossRefGoogle Scholar
  2. 2.
    Mansour-Ghanaei F, Yousefi Mashhour M, Joukar F, Sedigh M, Bagher-Zadeh AH, Jafarshad R. Prevalence of Helicobacter pylori infection among children in Rasht Northern Iran. Middle East J Dig Dis. 2009;1:84–8.Google Scholar
  3. 3.
    Malekzadeh R, Derakhshan MH, Malekzadeh Z. Gastric cancer in Iran: epidemiology and risk factors. Arch Iran Med. 2009;12:576–83.Google Scholar
  4. 4.
    Fock KM, Katelaris P, Sugano K, et al. Second Asia-Pacific Consensus Guidelines for Helicobacter pylori infection. J Gastroenterol Hepatol. 2009;24:1587–600.CrossRefGoogle Scholar
  5. 5.
    Vakil N. Primary and secondary treatment for Helicobacter pylori in the United States. Rev Gastroenterol Disord. 2005;5:67–72.Google Scholar
  6. 6.
    Lee M, Kemp JA, Canning A, Egan C, Tataronis G, Farraye FA. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med. 1999;159:2312–6.Google Scholar
  7. 7.
    Miner P, Katz PO, Chen Y, et al. Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: a five-way crossover study. Am J Gastroenterol. 2003;98:2616–20.CrossRefGoogle Scholar
  8. 8.
    Khademi F, Poursina F, Hosseini E, Akbari M, Ghasemian Safaei H. Helicobacter pylori in Iran: a systematic review on the antibiotic resistance. Iran J Basic Med Sci. 2015;18:2–7.Google Scholar
  9. 9.
    Jodlowski TZ, Lam S, Ashby CR Jr. Emerging therapies for the treatment of Helicobacter pylori infections. Ann Pharmacol Ther. 2008;42:1621–39.Google Scholar
  10. 10.
    Tursi A, Cammarota G, Montalto M, et al. Low-dose omeprazole plus clarithromycin and either tinidazole or amoxycillin for Helicobacter pylori infection. Aliment Pharmacol Ther. 1996;10:285–8.CrossRefGoogle Scholar
  11. 11.
    Chu KM, Kwok KF, Law SY, Wong J. One-week once-daily triple therapy for helicobacter pylori--a pilot study. Hepatogastroenterology. 2000;47:1624–6.Google Scholar
  12. 12.
    Iacopini F, Crispino P, Paoluzi O, et al. One-week once-daily triple therapy with esomeprazole, levofloxacin and azithromycin compared to a standard therapy for Helicobacter pylori eradication. Dig Liver Dis. 2005;37:571–6.CrossRefGoogle Scholar
  13. 13.
    Yee KCJ. Helicobacter pylori colonization of the oral cavity: a milestone discovery. World J Gastroenterol. 2016;14:641–8.CrossRefGoogle Scholar
  14. 14.
    Zaric S, Bojic B, Jankovic L. Periodontal therapy improves gastric Helicobacter pylori eradication. J Dent Res. 2009;10:946–50.CrossRefGoogle Scholar
  15. 15.
    Jia CL, Jiang GS, Li CH, Li CR. Effect of dental plaque control on infection of Helicobacter pylori in gastric mucosa. J Periodontol. 2009;80:1606–9.CrossRefGoogle Scholar

Copyright information

© Indian Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Faculty of MedicineIlam University of Medical SciencesIlamIran
  2. 2.Department of Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran

Personalised recommendations