EFFICACY OF MODIFIED DUAL THERAPY COMPARED TO STANDARD THERAPY FOR ERADICATION OF H. PYLORI: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Helicobacter pylori infection is a common global health concern. Standard triple therapy has declining effectiveness due to antibiotic resistance. Modified dual therapy (MDT) using high-dose PPI and amoxicillin offers an alternative. Objective: To compare the efficacy and safety of modified dual therapy with standard triple therapy for H. pylori eradication. Methods: A randomized controlled trial was conducted with 126 patients. Participants received either MDT (high-dose esomeprazole and amoxicillin) or standard triple therapy (esomeprazole, amoxicillin, clarithromycin) for 14 days. The primary endpoint was eradication confirmed by urea breath test. Secondary outcomes included adverse events and compliance. Results: Eradication rates were higher in the MDT group in both intention-to-treat (85.7% vs 74.6%, p=0.04) and per protocol analysis (89.8% vs 77.9%, p=0.03). Fewer adverse events occurred in the MDT group. Conclusion: Modified dual therapy is more effective and better tolerated than standard therapy, offering a viable first line treatment.