Helicobacter Pylori Eradication In Patients Research Articles

Relationship between obesity severity and Helicobacter pylori eradication in patients undergoing bariatric and metabolic surgery: A post hoc analysis.

The global prevalence of obesity is increasing and represents a major public health challenge. However, there is a paucity of data regarding Helicobacter pylori (H pylori) eradication in people with obesity. The aim of the study is to examine the influence of obesity degree on H. pylori eradication in patients undergoing bariatric and metabolic surgery. A post hoc analysis was conducted in a cohort of 204 adults patients (129 individuals diagnosed with obesity, 75 normal weight) H. pylori positive, included in two multicenter, prospective studies. Patients underwent a 14-day quadruple concomitant treatment, and H. pylori eradication was assessed using the 13C-urea breath test. The cohort was stratified according to body mass index (BMI), and statistical analyses were performed using chi-squared test, Kruskal-Wallis test, and logistic regression. Eradication rates were significantly lower in patients with obesity compared with normal weight individuals (68.2% vs. 88.0%, OR 0.29, 95% CI 0.13-0.63, p < 0.01). Furthermore, within the population diagnosed with obesity, the degree of obesity correlated with decreased eradication rates, with class 3 (BMI 40.0-49.9) and class 4 (BMI ≥ 50.0) obesity showing the lowest rates (67% and 51%, with an OR 0.28 and 0.15 respectively, p < 0.01). Our results indicate that obesity may influence H. pylori eradication, especially among severe obesity patients undergoing bariatric surgery, which could have implications for the development of ulcers and gastritis as well as the risk of gastric cancer. Tailored eradication strategies may be necessary to improve treatment efficacy in this population.

Efficacy and Safety of Postbiotic Contained Inactivated Lactobacillus reuteri ( Limosilactobacillus reuteri ) DSM 17648 as Adjuvant Therapy in the Eradication of Helicobacter pylori in Adults With Functional Dyspepsia: A Randomized Double-Blind Placebo-Controlled Trial.

Increasing the effectiveness of eradication therapy is an important task in gastroenterology. The aim of this study was to evaluate the efficacy and safety of postbiotic containing inactivated (nonviable) Limosilactobacillus (Lactobacillus)reuteri DSM 17648 (Pylopass) as adjuvant treatment of Helicobacter pylori eradication in patients with functional dyspepsia (FD). This randomized, double-blind, placebo-controlled, multicenter, parallel study included H. pylori -positive patients with FD. The postbiotic group received Pylopass 200 mg bid for 14 days in combination with eradication therapy (esomeprazole 20 mg bid + amoxicillin 1,000 mg bid + clarithromycin 500 mg bid for 14 days) and another 14 days after the completion of eradication therapy. The study was registered in the ISRCTN registry (ISRCTN20716052). Eradication efficiency was 96.7% for the postbiotic group vs 86.0% for the placebo group ( P = 0.039). Both groups showed significant improvements in quality of life and reduction of most gastrointestinal symptoms with no significant differences between groups. The overall number of digestive adverse effects in the postbiotic group was lower than in the placebo group. Serious adverse effects were not registered. The postbiotic containing inactivated L. reuteri DSM 17648 significantly improves the effectiveness of H. pylori eradication therapy in FD and decreases overall number of digestive adverse effects of this therapy.

Peculiarities of laboratory parameters dynamics during helicobacter pylori eradication in patients with rheumatoid arthritis

Helicobacter pylori (H. pylori) is able to participate in the pathogenesis of a number of autoimmune diseases, actively maintains chronic inflammation and stimulates the systemic immune response. The virulence factor of H. pylori is cytotoxin-associated gene A (CagA) is associated with more severe inflammatory reactions, increased risk of poor clinical outcomes and is able to influence the efficacy of infection eradication in patients with rheumatoid arthritis (RA).Purpose of the study. To evaluate laboratory parameters of H. pylori eradication efficacy in RA patients with chronic infection with the strain encoding cytotoxin-associated gene A.Materials and methods. Forty women with RA and confirmed chronic H. pylori infection were included in the study (mean age 55.5±8.7 years; mean disease duration 13.9±9.1 years; DAS-28–3.96±0.56). CagA-IgG associated H. pylori infection was diagnosed in 22 (group I, CagA+) and not diagnosed in 18 (group II, CagA-) patients. All RA patients underwent a course of H. pylori eradication therapy.Results. The process of H. pylori eradication had the most significant effect on laboratory parameters of CagA-negative RA patients (group II). In this group the levels of rheumatoid factor (p=0,028), C-reactive protein (CRP, p=0.001), interleukin-6 (IL-6, p=0.002), tumor necrosis factor alpha (p=0,023), angiopoietinlike protein type 3 (p=0.026) and antibodies to cyclic citrullinated peptide (ACCP, p=0,016) decreased significantly. In patients from group I (CagA+) most parameters remained practically unchanged (p&gt;0.05), except for CRP (p=0.01) and IL-6 (p=0.011). In the short term, the success of eradication in CagA+ patients was significantly lower than in CagA- patients (p=0.033). Moreover, confirmation of successful eradication of H. pylori within the established period of time was extremely rare (p=0.009) in the combination of CagA+ and high titers of ACCP and antibodies to modified citrullinated vimentin.Conclusions. The effectiveness of H. pylori eradication in RA patients depends on the presence of chronic infection with the strain encoding the cytotoxin-associated gene A and the level of antibodies to citrullinated proteins, which should be taken into account when choosing the therapeutic effect on H. pylori in this group.

Helicobacter pylori Eradication Therapy in Patients with Decreased Renal Function: A Systematic Review

Background: There are concerns that Helicobacter pylori eradication therapy may worsen kidney function in patients with decreased renal function. This study aimed to systematically review the literature regarding Helicobacter pylori eradication in patients with renal impairment. Methods: PubMed, the Cochrane Library, and Igaku Chuo Zasshi were searched for comparative studies on H. pylori eradication in patients with renal impairment. Results: Five articles were included in this systematic review. According to a randomized trial comparing a proton pump inhibitor (PPI) + clarithromycin + metronidazole and PPI + clarithromycin + amoxicillin in patients with decreased renal function, the incidence of acute renal failure was significantly lower in PPI + clarithromycin + metronidazole (2%: 1/44) than in PPI + clarithromycin + amoxicillin (18%: 8/44). The eradication rate in PPI + clarithromycin + metronidazole (92.5%) was significantly better than that in PPI + clarithromycin + amoxicillin (76.3%). According to four reports on eradication treatment using PPI + clarithromycin + amoxicillin in patients with and without decreased renal function, the eradication rates and adverse effects were similar in both groups. Regarding dose adjustment, three reports reduced the dose of antibiotics by half in patients with a creatinine clearance of 30 mL/min or less. Conclusions: The regimen with PPIs, clarithromycin, and metronidazole is recommended for renal impairment. The combination of PPIs, clarithromycin, and amoxicillin, at reduced doses depending on the renal function, is also a potential option.

Decision-Utility Analysis of Empiric Treatment Versus Test and Treat Strategies for Helicobacter pylori in Patients With Duodenal Ulcer

ObjectivesThe optimal strategy of Helicobacter pylori eradication in patients with duodenal ulcer is unclear. In this study, we aimed to compare the utility and the ulcer recurrence rate using the empiric treatment versus the test and treat strategies in patients with uncomplicated duodenal ulcer. MethodsA decision-utility analysis was performed using a decision tree. The empiric treatment strategy was compared with the test and treat strategy. The probabilities of recurrent ulcers were determined and utilities of the 2 strategies were compared using the quality-adjusted life-year (QALY). Sensitivity analysis was performed to evaluate for model robustness. ResultsThe probability of recurrent ulcer with the empiric strategy was 10.5%. The probabilities of recurrent ulcer with the test and treat strategy were 12.6%, 14.7%, 16.8%, and 17.9% based on 95%, 90%, 85%, and 80% sensitivity for histopathology, respectively. At the 95% estimate for the sensitivity of histopathology, the empiric strategy was associated with greater QALY compared with the test and treat strategy, 0.9875 versus 0.9853. The empiric treatment strategy was associated with greater QALY at extreme values for the estimates in our model. ConclusionsThe empiric treatment strategy is associated with 2.1% to 7.4% lower recurrence rate for a range of test sensitivity between 95% and 80%, and results in greater QALY compared with the test and treat strategy.

Эффективность применения природной минеральной воды «Увинская» в комплексной эрадикации Helicobacter pylori у больных хроническим гастритом на фоне сахарного диабета 2 типа

The purpose — to assess the effectiveness of therapeutic use of «Uvinskaya» natural mineral water for Helicobacter Pylori eradication in patients with chronic gastritis and type 2 diabetes mellitus. Material and methods. The study included 120 patients with type 2 diabetes mellitus, who were diagnosed with chronic gastritis associated with Helicobacter Pylori. The average age of patients was 61.6 ± 4.13 years, the duration of diabetes — from 2 to 15 years (on average – 9.9 ± 2.5 years), gender composition — 21 men and 99 women. The patients were divided into two groups by simple randomization. In the first group (n = 60), the first line eradication therapy was carried out according to Maastricht V recommendations, in the second group (n = 60) underwent eradication therapy combined with «Uvinskaya» mineral water. The diagnosis of «chronic gastritis» was histologically verified in all patients. The eradication control was carried out 4 weeks after therapy. Changes in the severity of gastroenterological symptoms in patients were determined by the Gastrointestinal Symptom Rating Scale questionnaire. Statistical processing was carried out with the calculation of average values and standard errors of the average. The differences were considered reliable at p ≤ 0.05. Results. The study shows the positive effect of the «Uvinskaya» mineral water inclusion into the Helicobacter Pylori eradication treatment complex in patients with type 2 diabetes mellitus: the condition of patients improved, inflammatory changes in the stomach mucosa were reduced and the efficiency of eradication therapy increased. Conclusion. The amplification of the positive therapeutic effects of drug treatment and drinking balneotherapy provides a significant increase in the efficiency of eradication, improving the clinical course and forecast of chronic gastritis associated with Helicobacter Pylori in patients with type 2 diabetes mellitus. It enables to recommend the intake of «Uvinskaya» mineral water as part of eradication therapy in patients with type 2 diabetes mellitus.

Role of Helicobacter pylori eradication in patients with functional dyspepsia.

Helicobacter pylori (H. pylori) is implicated in the pathogenesis of functional dyspepsia (FD). There is conflicting data regarding the benefit of H. pylori eradication for symptom relief in FD. To study the benefit of eradicating H. pylori in patients with FD as compared to standard medical treatment(SMT). Secondary aims were to find efficacy of H. pylori eradication therapy, recurrence of H. pylori after eradication, and predictors of efficacy. Consecutive adult patients of FD (ROME IV) with H. pylori infection presenting in the outpatient department of our hospital were enrolled. Patients with Global Overall Symptom (GOS) scale > 2 and H. pylori infection were included. Patients were randomized into two groups: group 1 received H. pylori eradication therapy and group 2 received SMT. Treatment success was defined as symptom relief (GOS score < 2 and reduction by at least 2 points at 6 months) and H. pylori eradication was defined as stool antigen negative at 4 weeks. Of 329 participants with FD, 253 were H. pyloripositive (rapid urease test and stool antigen test) (76.89%). After exclusions, 202 were randomized into two groups of 101 each. Thirty-two patients in group 1 and 31 in group 2 had treatment success (31.7% vs. 30.7%, p=1.000). The efficacy of H. pylori eradication therapy was 74.46% (70/94). H. pylori reinfection rate was 26.02% (19/73). H. pylori eradication therapy does not provide additional benefit in symptom relief in patients with FD as compared with SMT. NCT04697641 (retrospectively registered on www.clinicaltrials.gov in January 2021).

Efficacy of bismuth added to standard triple therapy as the first-line eradication regimen for Helicobacter pylori infection.

Addressing the increasing antibiotic resistance, including clarithromycin resistance, which affects Helicobacter pylori eradication therapy, is a challenge for clinicians. The objective of this study was to determine the efficacy of bismuth added to standard triple therapy as a first-line treatment regimen for Helicobacter pylori infection. The secondary outcome was the treatment efficacy for clarithromycin-resistant strains. A prospective study was undertaken from January to December 2019. A total of 107 patients with Helicobacter pylori infection were enrolled and received Helicobacter pylori eradication therapy with bismuth added to standard triple therapy for 14days. We also evaluated the clarithromycin resistance rate by dual-priming oligonucleotide-based multiplex PCR and treatment efficacy. A total of 104 patients completed standard triple therapy with bismuth added for Helicobacter pylori eradication. The eradication rates in the intention to treat and per-protocol analyses were 87.9% and 90.4%, respectively. The frequency of clarithromycin resistance was 33.6% (35/104), and the eradication rate was 77.1% in resistant strains (27/35). Bismuth added to standard triple therapy could be acceptable as a first-line treatment regimen for Helicobacter pylori eradication in patients with clarithromycin-resistant strains. In particular, in areas with high clarithromycin tolerance, it is advisable to consider bismuth add-on therapy as the first-line treatment regimen.

Efficacy of tailored second-line therapy of Helicobacter pylori eradication in patients with clarithromycin-based treatment failure: a multicenter prospective study

BackgroundAfter the failure of clarithromycin- and bismuth-based quadruple therapy (CBQT), levofloxacin- and bismuth-based quadruple therapy (LBQT) is recommended for Helicobacter pylori eradication. We compared the efficacies of second-line tailored bismuth-based quadruple therapy (TBQT) and empirical LBQT.MethodsPatients with CBQT failure were randomly assigned to receive TBQT or LBQT for 14 days. All patients underwent endoscopy for culture-based antibiotic susceptibility testing. Patients in the TBQT group exhibiting levofloxacin susceptibility were randomized to receive amoxicillin, levofloxacin, esomeprazole, and colloidal bismuth pectin (ALEB) or amoxicillin, furazolidone, esomeprazole, and colloidal bismuth pectin (AFEB) for 14 days; patients with levofloxacin resistance received AFEB.ResultsFrom May 2016 to June 2019, 364 subjects were enrolled. Eradication rates were significantly higher in the TBQT group (n = 182) than in the LBQT group (n = 182) according to both intention-to-treat (ITT) analysis (89.6% vs. 64.8%, P < 0.001) and per protocol (PP) analysis (91.1% vs. 67.8%, P < 0.001). Among patients in the TBQT group with levofloxacin susceptibility, eradication rates were similar in the ALEB (n = 51) and AFEB (n = 50) subgroups according to both the ITT (86.3% vs. 90.0%, P = 0.56) and PP (88.0% vs. 90.0%, P = 0.75) analyses. Isolated clarithromycin and levofloxacin resistance rates were 57.7% and 44.5%, respectively. The total clarithromycin and levofloxacin resistance rate in strains with dual or triple resistance was 35.7%.ConclusionsTBQT was more effective than LBQT as a second-line strategy after CBQT failure. In the absence of antibiotic susceptibility testing, AFEB therapy might be used as a rescue therapy to eradicate H. pylori and avoid levofloxacin resistance.Trial registration: Chinese Clinical Trial Registry (www.chictr.org.cn): ChiCTR1900027743.

The Effect of Helicobacter pylori Eradication in Patients with Gastroesophageal Reflux Disease: A Meta-Analysis of Randomized Controlled Studies

Aim: Helicobacter pylori infection has been established as a definite risk factor for gastric cancer. However, the consequence of H. pylori eradication on the progression of gastroesophageal reflux disease (GERD) remains controversial. The purpose of our study was to investigate the relationship between H. pylori eradication and the development of GERD. Methods: A comprehensive, English literature search was performed from January 1990 to April 2019. Only randomized controlled trials (RCT) that evaluated the effect of H. pylori eradication on GERD were included. Meta-analysis of pooled OR was performed using Review Manger 5.1.7. Results: Seventeen articles with 6,889 subjects (intention-to-treat) that fulfilled the inclusion criteria were finally included in the analysis. Of them, 8 RCTs have the similar study design and inclusion criterion, which included patients with H. pylori infection but without GERD at baseline. The OR for the development of erosive GERD after H. pylori eradication was 1.67 (95% CI 1.12–2.48, p = 0.01). The OR for the development of GERD-related symptoms after H. pylori eradication in eradication group compared with control group was 1.04 (95% CI 0.84–1.29, p = 0.71). In addition, 9 RCTs included patients with both baseline H. pylori infection and GERD. The OR for the healing rates and relapse rates after H. pylori eradication in the H. pylori eradication group vs. control group was 0.92 (95% CI 0.47–1.82, p = 0.82) and 1.12 (95% CI 0.60–2.09, p = 0.71), respectively. Conclusions: Our meta-analyses showed H. pylori eradication may lead to the development of new erosive GERD. However, eradication of H. pylori may affect neither the healing rates nor relapse rates of preexisting GERD.

Спорные вопросы эрадикации Helicobacter pylori у пациентов, принимающих прямые оральные антикоагулянты

Спорные вопросы эрадикации Helicobacter pylori у пациентов, принимающих прямые оральные антикоагулянты

Su1288 – First Line Helicobacter Pylori Eradication in Patients with Type 2 Diabetes Mellitus

Su1288 – First Line Helicobacter Pylori Eradication in Patients with Type 2 Diabetes Mellitus

Helicobacter pylori Eradication in Patients with an Iatrogenic Ulcer after Endoscopic Resection and Peptic Ulcer

Helicobacter pylori Eradication in Patients with an Iatrogenic Ulcer after Endoscopic Resection and Peptic Ulcer

Correction to: Effect of 25-hydroxyvitaminD on Helicobacter pylori eradication in patients with type 2 diabetes.

Correction to: Wien Klin Wochenschr 2018 https://doi.org/10.1007/s00508-018-1416-y The original version of this article unfortunately contained amistake.The spelling of Shengju Yan's name was incorrect. We apologize for this mistake.The original article has been ….

Effect of 25-hydroxyvitaminD on Helicobacter pylori eradication in patients with type2 diabetes.

SummaryBackgroundVarious studies have reported a lower Helicobacter pylori eradication rate and a more frequent reinfection rate in type 2 diabetes mellitus (T2DM). Vitamin D has anti-inflammatory and immunoregulatory activity and the role of the vitamin D receptor (VDR) in the antimicrobial activity against H. pylori has been reported. When it comes to the risk factors of H. pylori eradication, the function of vitamin D is not always taken into account. The aim of this study was to assess the role of 25-hydroxyvitamin D in H. pylori eradication in T2DM.MethodsIn this retrospective study data from 160 patients with T2DM who underwent eradication therapy for H. pylori in Anhui Provincial Hospital between July 2015 and September 2017 were analyzed. According to eradication status, patients were divided into two groups, the successful eradication group (n = 124) and the eradication failure group (n = 36). The following information was obtained from participants’ records before eradication treatment: age, sex, body mass index (BMI), duration of T2DM, prescription of medication use, smoking and drinking history. All patients were tested for glycated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL‑C), triglyceride (TG) and 25-hydroxyvitamin D (25-OHD) at baseline.ResultsThe H. pylori was eradicated in 124 (77.5%) patients, while in 36 (22.5%) patients the treatment was unsuccessful. The eradication failure group had a lower mean vitamin D concentration than the group with successful eradication (15.09 ± 7.72 ng/ml vs. 19.87 ± 6.35 ng/ml, p = 0.004). The estimated odds ratio (OR) for eradication failure in individuals with serum vitamin D deficiency (<20 ng/ml) compared to those with sufficient vitamin D levels (>30 ng/ml) were 1.489 (95% confidence interval, CI: 1.046–2.121, P = 0.027), Individuals with long duration of diabetes (≥10 years) had odds of eradication failure of 1.467 (95% CI: 1.017–2.114, P = 0.040) compared to subjects with short duration of diabetes (<10 years).ConclusionsLower 25-OHD was not only associated with H. pylori eradication failure but was also related to dyslipidemia in T2DM patients. Increasing serum 25-OHD to appropriate levels by activated vitamin D use may improve the eradication rate.

Effect of Helicobacter pylori Eradication on Low—Density Lipoprotein Cholesterol in Patients With Type 2 Diabetes

Introduction: Helicobacter pylori (HP) infection is associated with cytokine release,which affects the absorption of lipids and alters their metabolism.Accordingly,we hypothesized that eradication of HP would be associated with a decrease in low—density lipoprotein serum concentrations[sLDL]in patients with type 2 DM for whom the recommended[sLDL]is <100 mg/dl.Thus,the aim of this study was to investigate whether eradication of HP was associated with a decrease in[sLDL]in these patients at a community hospital that serves the multiethnic population of East Harlem,NY. Methods: Retrospective review of charts of adult patients coded as DM type 2 and HP infection from 1/2011 to 1/2016 because of feasibility.HP infection was diagnosed by stool antigen,rapid urease test,or histology.[sLDL] was documented 3 months(-3m)prior to diagnosis of HP and 3(+3m) and 6 months (+6m)after confirmation of HP eradication by any of the methods stated. Results: 928 patients were identified;of these,207 met study criteria.135 were male(65 %).Mean±SD [sLDL] was109.1±32 mg/dl(-3m)to HP infection as compared to 99±28,94.8±28(+3m)(+6m) after HP eradication,respectively(P<0.0001). Conclusion: HP eradication in patients with type 2 DM was associated with a significant decrease in[sLDL].It has been reported that the acute phase response induced by infections may alter lipid metabolism,which may result in increased triglycerides and decreased high—density lipoprotein cholesterol. Furthermore,experimental investigations have shown that inflammatory cytokines i.e.tumor necrosis factor-a,interferon-a,interleukin-1 and interleukin-6 influence lipid metabolism,among other mechanisms,by decreasing lipoprotein lipase activity and stimulating hepatic fatty acid synthesis,thus inducing a pro-atherogenic accumulation of triglyceride-rich lipoproteins.Because the inflammatory mediators involved in gastric mucosal responses to HP infection are the same as those involved in acute phase responses,it is possible that the sustained inflammatory response induced by gastric colonization with HP could elicit similar changes in the lipid profile of affected individuals.In this study,patients in whom behavioral interventions,change in dose,or had new lipid lowering agents prescribed within the study period were excluded.Accordingly, these data suggest that screening and treating HP in infected patients with type 2 DM may decrease their risk of cardiovascular disease.

Efficacy of bismuth containing quadruple therapies on Helicobacter pylori eradication in patients with history of antibiotic treatment

To investigate the efficacy of bismuth containing quadruple therapies on Helicobacter pylori (Hp) eradication in patients with history of antibiotic treatment. Methods: Hp infected patients (n=327) were allocated into 3 groups. Group A (n=52), patients had no antibiotic history and they took medicine of proton pump inhibitors (PPI) and livzon triple (clarithromycin, tinidazole, and bismuth); group B (n=80), patients had the antibiotic history except for amoxicillin and clarithromycin, and they were treated with PPI, amoxicillin, clarithromycin, and bismuth; group C (n=195), patients suffered failures of Hp therapy or with history of antibiotic abuse, and they were treated with PPI, doxycycline, furazolidone, and bismuth. Results: Both the intention-to-treat (ITT) analysis (group A 63.5%, group B 76.2%, group C 82.6%, P<0.05) and the pre-protocol (PP) analysis (group A 76.7%, group B 92.4%, group C 96.4%, P<0.05) showed significant difference among the 3 groups, revealing higher elimination in group B and C. The side-effects (20.2%) were mild and tolerable (group A, 28.0%; group B, 10.7%; group C, 22.0%). Conclusion: Proton pump inhibitors together with the livzon triple regimen have a low rate of Hp eradication and a higher incidence of adverse reactions. The quadruple therapy containing clarithromycin and metronidazole drugs can achieve the satisfactory outcomes based on patient's antibiotic history. For patients with multiple antibiotics, the quadruple therapy containing furazolidone and doxycycline may achieve the satisfactory outcomes, but the adverse resction would be relatively higher.

Prevalence of &lt;i&gt;Helicobacter pylori&lt;/i&gt; and the Interest of Its Eradication during the Functional Dyspepsia

Functional dyspepsia constitutes by its impact in quality of life and socio-economic impact areal public health problem (40% of the adult population in the Western world). The prevalence of infection with Helicobacter pylori (HP) in patients with functional dyspepsia is about 30% - 70%. The aim of our study is to observe the improvement of functional dyspepsia (FD) after Helicobacter pylori (HP) eradication. Methods: This is a prospective study over a period of 68 months (May 2009 - January 2015). We included all patients aged over 15 years, with functional dyspepsia defined by the Rome III criteria. The diagnosis of HP was made by histology and/or PCR. Patients infected with HP were treated in single-blind: standard triple therapy for 7 days or sequential treatment for 10 days. HP eradication control was made after: 3 months, 6 months and one year of treatment. Results: During the study period, 1190 patients were included of which 250 patients (21%) were in functional dyspepsia according to the Rome III criteria. The average age in patients with functional dyspepsia was 49 years [16 - 80], sex ratio M/F was 0.58 (N = 92/158). 60% of patients were older than 45 years (N = 150). Chronic smoking was found in 20% of patients (N = 50). One hundred and seventy five patients (70%) had HP infection (N = 175). One hundred and sixty five patients received the treatment of Helicobacter pylori (94.28%), 10 patients were lost to follow (5.71%). The eradication of HP was obtained in 98.41% with sequential treatment versus 88.73% with standard triple therapy (p = 0.026). All patients were reviewed at 3 months and 6 months after treatment, 86% were reviewed at 12 months (N = 143). Dyspeptic symptoms was disappeared in 43% of our patients (N = 71) partial disappearance of symptoms in 34.5% of cases (N = 57) persistence of symptoms in 22.42% of cases (N = 37). Conclusion: In our study the prevalence of Helicobacter pylori infection in patients with functional dyspepsia is high: 70%. Sequential therapy is better than the standard triple therapy in the eradication of HP in patients with nonulcer dyspepsia, which improves their symptoms in more than 50% of cases.

Effect of telephone follow-up on compliance and Helicobacter pylori eradication in patients with Helicobacter pylori infection

To evaluate effect of telephone follow-up combined with written instruction on compliance and Helicobacter pylori (H. pylori) eradication in patients with H. pylori infection. Methods: A total of 160 H. pylori positive patients were randomly divided into an experimental group and a control group (n=80 in each group). All the patients got the guide instruction named "the guidance of clinical medication for H. pylori infection patients" before the treatment. The patients in the experimental group were added individualized follow-up with telephone. The compliance, eradication of H. pylori, adverse events, and satisfaction were compared between the 2 groups. Results: The eradication rate of H. pylori in the perprotocol analysis for the experimental group and control group were 64.4% (47/73) and 56.5%(35/62), respectively (P=0.380), while in the intention-to-treat analysis, the rates were 58.8% (47/80) and 43.8% (35/80, P=0.082), respectively. The compliance rate in the experimental group was significantly higher than that in the control group (91.3% vs 77.5%, P<0.05). There was significant difference in patients' satisfaction in good ones (75.3% vs 51.6%) and poor ones (5.5% vs 21.0%) between the 2 groups (P<0.05). There were 11 patients in the experimental group and 36 patients in the control group, who appeared adverse reactions such as nausea, bad breath, abdominal distention, poor appetite, and defecation habit change during the process of eradicating H. pylori, but the occurrence rate in the experimental group was obviously lower than that in the control group (15.1% vs 58.1%, P<0.05). Conclusion: The telephone follow-up cannot increase the H. pylori eradication rate, but it can improve compliance and satisfaction for the patients and relieve adverse effects.

Ten days of levofloxacin-containing concomitant therapy can achieve effective Helicobacter pylori eradication in patients with type 2 diabetes

Background: This study investigated whether levofloxacin-containing concomitant therapy can effectively eradicate Helicobacter pylori infection in patients with type 2 diabetes mellitus (T2DM).Methods: A total of 797 T2DM patients were screened for anti-H. pylori IgG antibodies, and the presence of H. pylori infection was confirmed by 13C-urea breath test. We prospectively randomized 114 of these patients to receive either 10 d of levofloxacin-concomitant therapy (n = 55) or sequential therapy (n = 59). Antimicrobial resistance of H. pylori isolates collected from the patients with T2DM (n = 109) and dyspeptic controls without DM (n = 110) was determined using the E-test. This study was approved by our Institutional Review Board (A-BR-103-021).Results: The H. pylori eradication rates with concomitant therapy were higher than sequential therapy in both intention-to-treat (96.4% versus 81.4%, p = 0.012) and per-protocol (100% versus 85.4%, p = 0.006) analysis. The adverse effects in both groups were similarly mild. In the patients who received sequential therapy, clarithromycin resistance was significantly associated with eradication failure (p = 0.02). There were no significant differences in the antibiotic-resistant rates to amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin between the patients with and without T2DM.Conclusions: Ten days of levofloxacin-containing concomitant therapy is an effective and well-tolerated treatment to eradicate H. pylori infection for T2DM patients.Key messagesTen days of levofloxacin-containing concomitant therapy is well tolerated and superior to clarithromycin-containing sequential therapy for first-line H. pylori eradication in patients with type 2 diabetes.Clarithromycin resistance to H. pylori is the main factor associated with eradication failure in clarithromycin-containing sequential therapy in diabetic patients.