In 208 patients with Helicobacter pylori (H. pylori) infection, the eradication rate of 10-day four times daily (q.i.d.) dual therapy was found to be unacceptable (<85%). On the other hand, the 14-day three times daily (t.i.d.) dual therapy was borderline acceptable for first-line treatment. The two dual therapies demonstrated few adverse effects and were well tolerated.

A randomized open-label controlled trial was conducted to investigate the safety and efficacy of two modified regimens of esomeprazole-amoxicillin dual therapies, 10-day q.i.d. and 14-day t.i.d. dual therapy, and assess the factors that might affect the eradication rates in 208 H. pylori-infected patients.

The study was conducted in Chongqing from July 2018 to April 2019. Participants were randomly allocated to either 10-day dual therapy (esomeprazole 20 mg and amoxicillin 750 mg, all given four times daily) group (n=104) or 14-day dual therapy (esomeprazole 20 mg and amoxicillin 1000 mg, all given three times daily) group (n=104). The primary outcome was the eradication rate of H. pylori was the primary endpoint. The patient compliance and the frequency of adverse events were the secondary endpoints.

The adverse event rates, the eradication rates for 10-day and 14-day groups as first-line therapies and as rescue therapies in the intention-to-treat analysis is depicted in the following table:

Compliance and smoking remarkably affected the efficacy of proton pump inhibitor (PPI)-amoxicillin dual therapies.

PPI-amoxicillin dual therapy has a significant potential to be an effective H. pylori eradication regimen.