Comparison Between One Week Versus Two Weeks Vonoprazan and High Dose Amoxicillin Dual Therapy for Eradication of Helicobacter Pylori in Egyptian Patients

Abo Elkasem, Asmaa Hussien; Ghoniem, Hossam Mahmoud Sabry; Abdel Fattah, Ali Mohammed; Fahmy, Al Zahraa Mohammed

doi:10.21608/ejmr.2025.390978.1839

Comparison Between One Week Versus Two Weeks Vonoprazan and High Dose Amoxicillin Dual Therapy for Eradication of Helicobacter Pylori in Egyptian Patients

Document Type : Original Article

Authors

Tropical Medicine Department, Faculty of Medicine Bani-Suef University

10.21608/ejmr.2025.390978.1839

Abstract

Background: Helicobacter pylori infection is highly prevalent and associated with several gastrointestinal and extra-gastrointestinal diseases. Traditional eradication regimens face increasing antibiotic resistance, particularly to clarithromycin. Vonoprazan, a novel potassium-competitive acid blocker, offers promising acid suppression with potential to enhance eradication when combined with amoxicillin. This study aimed to compare the efficacy and safety of a 1-week versus 2-week vonoprazan and high-dose amoxicillin dual therapy in Egyptian patients with H. pylori infection. Methods: This cohort comparative observational study was conducted at Bani-Suef University Hospital over six months, enrolling 60 adult patients with confirmed H. pylori infection. Patients were randomized into two groups: Group A received vonoprazan 20 mg twice daily and amoxicillin 1 g three times daily for 14 days, while Group B received the same regimen for 7 days. Eradication was confirmed by stool antigen testing two weeks’ post-therapy. Adverse effects and patient compliance were monitored. Results: The eradication rate was 80% in Group A and 76.7% in Group B, with no statistically significant difference (p > 0.05). Reported side effects were mild and similar in both groups (20% vs. 23.3%, p > 0.05), with no severe adverse events. Multivariate analysis revealed no significant predictors of treatment response. Conclusion: One-week and two-week dual therapies with vonoprazan and high-dose amoxicillin yielded comparable eradication rates and tolerability in Egyptian patients. Shorter therapy may be a viable, cost-effective alternative in clinical practice.

Keywords

Main Subjects

Internal medicine ·

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