Comparison of Efficacy of Triple Regimen Based on Clarithromycin VS Metronidazole in Children

NCT ID: NCT04721704

Last Updated: 2021-01-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-14

Study Completion Date

2022-09-14

Brief Summary

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All children from 1day to 18years of age, diagnosed with peptic ulcer disease due to H pylori at Pakistan Institute of Medical Sciences, Islamabad, from July 2020 to December 2021 will be included in the study. After informed written consent from parents/ guardians patients' bio data along with history and examination will be recorded on a proforma. They will be allocated into two groups, group A and group B randomly based on treatment regimen offered.

Group A: Amoxicillin AMO + Clarithromycin CLA + Proton pump inhibitor PPI) Group B: Amoxicillin AMO+ Metronidazole MET+ Proton pump inhibitor PPI The history will include presenting symptoms along duration, remission of symptoms after therapy and clinical outcome will also be recorded.

Detailed Description

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Helicobacter pylori is a gram-negative bacillus responsible for one of the most common infections found in humans worldwide1. In general, the prevalence is high in developing countries and the infection is acquired at a young age. Most children infected with H pylori are asymptomatic. Antral gastritis is the most common manifestation in children. Duodenal and gastric ulcers may be associated with H pylori gastritis in 1.8 % children2. Antibiotic resistance is the major cause of failure in the treatment of H pylori infection3. Most of the studies worldwide confirmed an increase in macrolide resistance, while metronidazole resistance either decreased or remained stable. In a prospective multicenter European study, primarily comprised of adults, found a 31.8% resistance rate to clarithromycin and 25.7% to metronidazole in the study4.

If the strain is resistant to one of the antibiotics used, treatment success will be compromised5. As a result therapies that are recommended should be based on antibiotic susceptibility testing. If this testing is not available, then clarithromycin-based triple therapy should not be used as part of first-line therapy due to high rates of clarithromycin resistance rates6 The European Society for Paeditric Gastroenterology Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition made the recommendations in 2017 for the Management of Helicobacter pylori in Children that antimicrobial sensitivity should be obtained for the infecting H pylori to tailor eradication therapy accordingly and the effectiveness of first-line therapy should be evaluated in national/regional centers7.

If the strain is susceptible to clarithromycin (CLA) and to metronidazole (MET), triple therapy (PPI, amoxicillin \[AMO\], CLA) for 14 days and doses of proton pump inhibitor and antibiotics should be calculated based on the bodyweight8.

We aim to study efficacy and safety of clarithromycin vs metronidazole based triple regimen for the eradication of H pylori in children with peptic ulcer disease.

Conditions

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H Pylori Gastritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group A

Group A will be given Amoxicillin AMO + Clarithromycin CLA + Proton pump inhibitor PPI based triple regimen

Group Type EXPERIMENTAL

Clarithromycin+ Amoxicillin + Omeprazole

Intervention Type DRUG

In Group A: Amoxicillin AMO + Clarithromycin CLA + Proton pump inhibitor PPI will be given to children

Group B

Group B will be given Amoxicillin AMO+ Metronidazole MET+ Proton pump inhibitor PPI based triple regimen

Group Type EXPERIMENTAL

Metronidazole +Amoxicillin + Omeprazole

Intervention Type DRUG

Group B: Amoxicillin AMO+ Metronidazole MET+ Proton pump inhibitor PPI

Interventions

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Clarithromycin+ Amoxicillin + Omeprazole

In Group A: Amoxicillin AMO + Clarithromycin CLA + Proton pump inhibitor PPI will be given to children

Intervention Type DRUG

Metronidazole +Amoxicillin + Omeprazole

Group B: Amoxicillin AMO+ Metronidazole MET+ Proton pump inhibitor PPI

Intervention Type DRUG

Other Intervention Names

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Klaricid + Amoxil + Risek Flagyl + Amoxil + Risek

Eligibility Criteria

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Inclusion Criteria

* 1\. All children age 1-12 years having H-pylori gastritis

Exclusion Criteria

* drug induced gastritis critically ill child
Minimum Eligible Age

1 Year

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shaheed Zulfiqar Ali Bhutto Medical University

OTHER

Sponsor Role lead

Responsible Party

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Dr.Nadia waheed

Assistant professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nadia Waheed

Role: PRINCIPAL_INVESTIGATOR

PIMS, SZABMU,ISLAMABAD

Locations

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Pakistan Institute of Medical Sciences,SZABMU

Islamabad, Capital Territory, Pakistan

Site Status RECRUITING

Pakistan Institute of Medical Sciences, Islamabad

Islamabad, Islamabad, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Nadia Waheed

Role: CONTACT

923334461116

Nighat Haider

Role: CONTACT

923212125768

Facility Contacts

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Nadia W,aheed, FCPS

Role: primary

923334461116

Nighat Haider, FCPS

Role: backup

923212125768

Nadia W,aheed, FCPS

Role: primary

923334461116

Nighat Haider, FCPS

Role: backup

923212125768

Other Identifiers

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F-.1-1/2015/ERB/SZABMU/646

Identifier Type: -

Identifier Source: org_study_id

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