Helicobacter pylori eradication in renal recipient: triple or quadruple therapy?

Although triple (omeprazole, amoxicillin, and metronidazole) and quadruple (omeprazole, tetracycline, metronidazole, and bismuth subcitrate) therapeutic regimens for H. pylori eradication has been studied much in the general population, there is a lack of data in renal transplanted patients. So, this study aimed at comparing regimens in these patients who were considered being immunocompromised. The present clinical trial was carried out in Mashhad, Iran in 2010. Fifty-five patients who had received a kidney transplant in six months or earlier and referred for chronic dyspepsia were selected. They were resistant to H2-receptor antagonists or proton pump inhibitors therapy and had positive Rapid ‎Urea Test. They randomly divided into two groups: triple and quadruple therapy. The treatment duration in both groups was similar (antibiotics for two weeks plus omeprazole for 4 weeks). Urea Breath Test (UBT) was performed two weeks after treatment for assessment of its result. Total numbers of 39 patients (71%) were positive for H. Pylori which were divided into triple therapy group (21 patients) and quadruple therapy (18 patients). Overall, the treatment was successful in 80% (71% in triple therapy and 89% in quadruple one) which was not different significantly between the groups (p=0.247). The result of this study revealed that the prevalence of H. pylori infection in renal transplant patients is similar to the normal population. In these cases, triple and quadruple therapies were similar in eradication of H. pylori. So, triple therapy can be recommended in renal transplant recipients.