en Gastroentrology Gastroentrology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:14pt"><b><i><span style="color:blue">Background</span></i></b><i><span style="color:blue">:</span></i> <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is strongly related to peptic ulcer disease, chronic gastritis, and gastric malignancies. Therefore, <i>H. pylori</i> eradication is necessary in these cases. This study was aimed to compare the efficacy of 14-day reverse hybrid therapy with standard 14-day concomitant regimen for <i>H. pylori</i> eradication in Iran.</span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Methods:</span></i></b> Of the 317 patients with dyspepsia and <i>H. pylori</i> infection enrolled in the study, 153 and 164 patients were randomly assigned to reverse hybrid and concomitant groups, respectively. The reverse hybrid regimen containing pantoprazole, amoxicillin, clarithromycin, and metronidazole was taken every 12 hours in the first 7 days, however, Clarithromycin and Metronidazole were discontinued within the next 7 days. Patients in the concomitant group also received the same drugs for 14-day. Eradication confirmation <span lang="EN">tests </span>were used 8 weeks after the end of treatments.<span style="font-size:10.0pt"></span></span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Results:</span></i></b> <span lang="EN">A crowd of 281 patients continued&nbsp;the&nbsp;trial&nbsp;until the end. <i>H. pylori</i> eradication rates based on intention to treat analysis were 71.2% (109/153) and 83.5% (137/164) in </span>reverse hybrid<span lang="EN"> and </span>concomitant <span lang="EN">groups, </span>respectively<span lang="EN"> (</span><i>P</i><span lang="EN"> = 0.007). </span>By the per-protocol analysis, rates of eradication were 85.8% (109/127) and 89% (137/154), respectively (<i>P</i> = 0.428).<span lang="EN"> Severe side effects were few in both groups. More side effects were observed in </span>concomitant <span lang="EN">group (</span><i>p</i><span lang="EN"> < 0.001), however, the severity of side effects was not statistically different between the two </span>regimens <span lang="EN">(</span><i>P</i><span lang="EN"> = 0.314).</span> Reverse <span lang="EN">hybrid regimen was better tolerated (98% vs. 91.5%, <i>P</i>= 0.009)</span>.<span style="font-size:10.0pt"></span></span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Conclusion</span></i></b><i><span style="color:blue">:</span></i> Both 14-day reverse hybrid and concomitant regimens have a fair response rate in Iran.<span style="font-size:10.0pt"></span></span></span></span><br> &nbsp; Concomitant, Eradication regimens, Helicobacter pylori infection, Reverse hybrid, Randomized controlled trial 687 693 http://caspjim.com/browse.php?a_code=A-10-2802-1&slc_lang=en&sid=1 seyed Mohammad Valizadeh Toosi seyedmohammadv@yahoo.com 100319475328460044930 100319475328460044930 No Non-communicable Diseases Institute, Gut and Liver Research Center, Imam Khomeini Hospital, Sari, Iran Vahid Hosseini dr.vahid47@gmail.com 100319475328460044931 100319475328460044931 No Non-communicable Diseases Institute, Gut and Liver Research Center, Imam Khomeini Hospital, Sari, Iran Hajar Shokri-Afra h.shokriafra@mazums.ac.ir 100319475328460044932 100319475328460044932 No Non-communicable Diseases Institute, Gut and Liver Research Center, Imam Khomeini Hospital, Sari, Iran Iradj Maleki IMaleki@mazums.ac.ir 100319475328460044933 100319475328460044933 Yes Non-communicable Diseases Institute, Gut and Liver Research Center, Imam Khomeini Hospital, Sari, Iran