Determination of efficacy, adverse drug reactions and cost effectiveness of three triple drug regimens for the treatment of Helicobacter pylori infected acid peptic disease patients

ObjectiveTo evaluate the clinical outcome and Helicobacter pylori (H. pylori) infection status by GLQI and PCR, before and after the triple (CMO, CAO or LTC) treatment regimen.MethodsSalivary samples of 225 patients of acid peptic disease were used to determine the infection status and GLQI score before and after treatment regimen. Information regarding direct/indirect costs and side effects were determined using validated questionnaires.ResultsInfection status was determined by successful amplification of 16s r RNA and Cag T genes. Positive eradication rate was 72.7% in males and 70% in females in CMO treated, 88.13% in males and 87.5% in females in CAO treated and 84.44% in males and 96.67% in females in LTC treated patients. The highest improvement in the GIQOL score after the treatment regimen was visible in the LTC treated group with a change of 65.39, followed by CAO treated patients with a change of 49.73 and CMO treated patients with an improvement of 32.18. The average cost effectiveness ratio was found to be best in the CAO treatment regimen with a ratio of 9.43 followed by LTC treatment regimen with a ratio of 11.74 and CMO with a ratio of 49.13. Side effects like diarrhea, nausea, bad taste and metallic taste were significantly enhanced in CMO (P< 0.001) when compared to CAO and LTC treatment regimens.ConclusionsThe present investigation suggests that LTC is efficacious and bears less side effects, but CAO is most cost effective amongst the three treatment regimens. PCR assay can be scaled up for hospitals or clinics as a cost effective non invasive diagnostic test.