الفهرس 
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Abstract
An illness caused by Helicobacter pylori (also known as H. pylori) is regarded as the most common kind of bacterial infection found in humans, since it affects nearly half of all people on the planet. However, the frequency of this problem varies significantly between rich nations and underdeveloped ones. An infection with H. pylori may lead to a number of different conditions, such as gastroduodenal and extra-gastroduodenal illnesses, as well as peptic ulcer disease and stomach cancer.
It is believed that the prevalence of H. pylori in children in Egypt varies from 13 percent to 72 percent, while the prevalence in adults is predicted to vary from 26 percent to 90 percent. The H. pylori infection may be diagnosed primarily by the use of serology, the detection of H. pylori stool antigen, and the histological study of stomach tissue.
Emerging antibiotic resistance has led to lower rates of H. pylori eradication, which has resulted in Helicobacter pylori infection being extremely resistant to the typical treatment regimens used as the first line of defense against the infection. Therefore, there is a significant amount of interest in doing research on novel antibiotic combinations and treatment plans.
Standard triple therapy has been the treatment that has been recommended the most by guidelines. This treatment consists of a proton pump inhibitor (PPI) and two antibiotics (most commonly clarithromycin, and either amoxicillin, or a nitroimidazole), and it is typically administered for a period of seven to ten days. In many regions of the globe, triple therapy is no longer useful as a treatment option because of rising incidences of clarithromycin resistance.
The aim of this study is to compare the therapeutic efficacy of vonoprazan based versus conventional PPI based triple therapy for the eradication of H.pylori infection in Egyptian patients.
This study was an observational cohort study performed on 80 patients recruited from the outpatient Clinic of the Endemic Medicine Department, Beni-Suef University Hospital. The study included Egyptian patients who had a diagnosis of H. pylori infection based on a positive H. pylori stool antigen test or positive histopathology for H. pylori in an endoscopic biopsy.
Patients were randomly allocated into:
• PCA group (40 patients): assigned to receive conventional PPI based triple therapy (40 mg of proton pump inhibitor (PPI) twice daily +amoxicillin 1g twice daily + clarithromycin500 mg twice daily) for 14 days.
• VA group (40 patients): assigned to receive vonoprazan based therapy (20 mg of vonoprazan twice daily + 1 g amoxicillin 3times daily) for 14 days.
The main findings of our study was:
The mean age was (33.8±13.3)years, with 70% were females, 71.3% inhabitant rural area, 15% were smokers, and 8.8% had co-morbidities. The most common co-morbidities were DM and HTN affecting (25%) of patients in Vonoprazan group and (33.3 %) in triple therapy group.
This study revealed that there was a statistically significant difference between the two treatment regimens as regards response to treatment with higher percentage of response being noticed among the group treated with Vonoprazan dual therapy (70%) compared to (40%) in the PPI triple therapy group.
As regards the side effects of the drugs, 12 (30%) patients in vonoprazan group reported side effects in the form of nausea (3 patients), fatigue and dizziness (4 patients), abdominal pain (4 patients) and headache (1 patient). In the same way, 10 (25%) patients in triple therapy group reported side effects in the form of nausea (3 patients), fatigue and dizziness (4 patients) and abdominal pain (3 patients).
There was no statistically significant difference in hemoglobin level among the group treated with Vonoprazan dual therapy compared to the triple therapy group. Also, there was no statistically significant as regards TLC, PLT, and creatinine level for Vonoprazan dual therapy and triple therapy groups respectively.