Evaluation of the efficacy and safety of different regimens for Helicobacter pylori eradication therapy during the COVID-19 pandemic and post-pandemic period in Ukraine: a retrospective observational study

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Background. COVID-19 pandemic has negatively affected treatment of H.pylori and has long-term consequences, in particular, bacterial susceptibility decrease to broad-spectrum antibiotics used for typical H.pylori eradication. Currently, there is limited scientific data on the effectiveness and safety of standard eradication regimens in the post-COVID period. The aim of the study is to investigate the effectiveness and safety of 10- and 14-day H.pylori eradication regimens used in 2022–2025 and to compare them with the effectiveness and safety of 10-day regimens used over 2019–2021 in Ukraine, as well as to identify the relationship between unsuccessful treatment cases and anamnestic data. Materials and methods. We conducted retrospective multicenter observational study for 2019–2025. A comparative analysis on the effectiveness and safety of various eradication regimens in group I (n = 82) and group II (n = 74) was performed. We determined frequency, intensity, and spectrum of side effects in both groups. A multivariate regression analysis of the relationship between unsuccessful treatment cases and anamnestic data was conducted. Results. Comparative analysis revealed no statistical difference in the eradication rates between groups I and II (p ≥ 0.05). The lowest eradication rate among patients in group II was detected on three-component regimens ESO + CA (67 %) and PANTO + CM/T (70 %). The highest eradication rate was on quadruple regimen ESO + LAF (100 %). In group II, the frequency of side effects, their intensity, and spectrum significantly increased after 14-day treatment (p < 0.001) compared to group I. Regression analysis revealed that male gender, history of COVID-19 infection, and first treatment attempts were significantly more frequently associa­ted with unsuccessful treatment (p < 0.05). Conclusions. Standard 14-day three-component H.pylori eradication regimens ESO + CA, PANTO + CM/T, PANTO + AM/T have unacceptable eradication rates (≤ 70 %). The 14-day quadruple ESO + LAF regimen demonstrates a high eradication rate (> 90 %), but is accompanied by frequent and diverse side effects, reduced adherence to treatment. Treatment failure is significantly associated with male gender, previous COVID-19 infection, and first treatment attempts.