Efficacy of Standard Triple Therapy in the Treatment of Helicobacter pylori Infection: Experience from Kuwait

Abstract

Recent studies suggest that the initial treatment success rates for H. pylori infection are falling below 80% in many parts of the world. The aim of this study was to evaluate the efficacy of standard triple therapy in the treatment of H. pylori infection in Kuwait. Consecutive H. pylori positive patients were enrolled in the study to receive clarithromycin, amoxicillin and omeprazole for 10 days. H. pylori status was checked with 13C urea breath test 6 weeks after the end of therapy. Endoscopic findings was recorded in all patients. One hundred forty-one patients (82 male and 59 females; mean age 41.8 years) were enrolled in the study. A total of seven patients were excluded from the per protocol analysis. The eradication rates in intention to treat (ITT) and per protocol (PP) were 72.3% (95% CI 64.2-79.5%) and 76.1% (95% CI 68-83%), respectively. The main endoscopic findings were normal in 47.5% and gastritis in 37.6%. The efficacy of the current standard triple therapy for H. pylori eradication in our community is suboptimal. Confirmation for H. pylori eradication with noninvasive tests is recommended, especially in high-risk patients. New antimicrobial regimens for H. pylori eradication are considered necessary.