Mastic Gum as an Adjunct to Antibiotics for Helicobacter pylori Eradication: A Randomized Controlled Trial

Background: Helicobacter pylori infection is highly prevalent worldwide and can cause serious complications, necessitating effective eradication regimens. Rising antibiotic resistance has reduced the efficacy of the standard triple therapy involving antibiotics, proton pump inhibitors (PPIs), and bismuth. Mastic gum exhibits promising antibacterial properties and may enhance eradication rates when combined with standard treatment, potentially limiting resistance. This study evaluates a modified triple regimen incorporating mastic gum for H. pylori eradication, providing insights into alternative treatment options. Methods: In this randomized controlled trial (Trial Registration: NBEAH-۲۰۲۳-۰۰۱), ۳۶۰ H. pylori-positive patients were assigned to two groups: Group A received standard triple therapy (clarithromycin, amoxicillin, and omeprazole), and Group B received the same triple therapy plus mastic gum capsules for ۱۰ days. H. pylori infection was confirmed pre-treatment by urea breath and fecal antigen tests. Eradication rates post-treatment were compared using chi-square tests, with significance set at p≤۰.۰۵. Data analysis was performed using SPSS version ۲۰. Results: In Group B (n=۱۸۰), ۱۴ patients (۷.۸%) remained H. pylori-positive after treatment, yielding a ۹۲.۲% eradication rate. In Group A (n=۱۸۰), ۶۶ patients (۳۶.۷%) remained positive, yielding a ۶۳.۳% eradication rate. The difference in eradication rates was statistically significant (P≤۰.۰۰۱). Conclusion: Adding mastic gum to standard triple therapy significantly improves H. pylori eradication rates. This combination may serve as an effective alternative, particularly in antibiotic-resistant infections, and could help reduce antibiotic use and resistance development.