Kumar, Victa Vinay, Paterson, Claudia, Hill, Andrew and Sharma, Vikash (2025) Efficacy of ‘Triple Therapy’ in Eradicating Ulcer Related Helicobacter pylori Infection at a Tertiary Hospital in Fiji—A Pilot Study. Efficacy of ‘Triple Therapy’ in Eradicating Ulcer Related Helicobacter pylori Infection at a Tertiary Hospital in Fiji—A Pilot Study, 01 (05): 70231. pp. 1-5.
ABSTRACT
Background: Fiji currently uses a seven-day Clarithromycin based triple therapy regimen for Heliobacter pylori (H. pylori)
eradication, and the local eradication rate is unknown. H. pylori testing is performed using a rapid urease test (RUT) during
gastroscopy in Fiji.
Methods: A year-long prospective observational study was undertaken at the Colonial War Memorial Hospital in Fiji. Eligible
participants included patients who had peptic ulcer disease (PUD) on gastroscopy and a positive RUT. Consenting participants
were prescribed Clarithromycin based triple therapy for 7days, and underwent a second gastroscopy with RUT after 6 to 8weeks.
Participants who tested positive on a repeat RUT received Clarithromycin based triple therapy for 14days, and underwent a third
gastroscopy and RUT. Participants who remained positive for H. pylori were prescribed quadruple therapy for 14days.
Results: Forty-nine patients were enrolled in the study. Thirty-six (73.5%) had a negative RUT after a seven-day Clarithromycin�based regimen. Eleven of the 13 participants who remained positive eradicated H. pylori after being given another course of
the same regimen for 14days, resulting in a final eradication rate of 95.9%. The remaining two participants received quadruple
therapy for 14days.
Conclusion: This study demonstrates an eradication rate of 73.5% using a seven-day Clarithromycin-based regimen in Fiji
among H. pylori positive patients with PUD on gastroscopy. This was significantly improved using a 14-day regimen. H. pylori
has reduced susceptibility to the current seven-day Clarithromycin based regimen. Future local guidelines should extend to
14days to achieve a greater eradication rate.
JEL Classification: Upper Gut
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