Efficacies of Reverse Hybrid Therapy in Eradication of Helicobacter pylori Infection

Introduction: Because the prevalence of antibiotic resistance markedly increases with time worldwide, anti-H. pylori treatment is continuing to be a great challenge for physicians in clinical practice. Eradication of H. pylori infection markedly changes the natural history of peptic ulcer in patients with duodenal or gastric ulcer. Most peptic ulcers associated with H. pylori infection are curable. Aim of present study was to study the efficacies of 14 days ‘ Reverse Hybrid Therapy’ in H.pylori positive G.I.patients. Material and methods: 100 H.pylori positive patients with upper G.I. complaints who underwent upper GI endoscopy were included in the study. H.pylori infection was documented by at least 2 positive results of Rapid Urease Test. Subjects with any of the following criteria were excluded from the study. 1. Previous eradication therapy 2. Allergy to any antibiotic used in study. 3. Coexistence of any serious illness. 4. Pregnancy or lactating women 5. Previous gastrectomy 6. Use of antibiotics within last 4 week. Detailed medical history and demographic details of the patients were recorded. Routine haematogical tests and USG was done. Patients were given 14 days dual therapy ie quadruple regimen (proton pump inhibitor + amoxicillin + clarithromycin + metronidazole) for first 7 days followed by dual regimen of PPI+ amoxicillin for next 7 days. Patients were asked to report at 7, 14 days and at 6 weeks interval. Results: Out of 97 patients 93 patients became negative for H.pylori after 6 week of Reverse Hybrid eradication therapy. It was observed that majority of patients enrolled in the study were in the age group of 41–60 years (50%) followed by below 40 yrs (27%), above 60 yrs (23%). Out of them, 74% were male and 26% were female. Conclusion: Out of 97 patients 93 patients became negative for H.pylori after 6 week of Reverse Hybrid eradication therapy. Hence, Reverse Hybrid Therapy is equally potent therapy to Bismuth based therapy though the latter has a lot of side effects.