Helicobacter Pylori Eradication Rates Research Articles

Comparison of Helicobacter pylori eradication regimens in patients with end stage renal disease.

The aim of this study was to compare the Helicobacter pylori (HP) eradication regimens in patients with end stage renal disease. In patients undergoing hemodialysis, the pathologic changes seen in the stomach may be the result of high serum levels of gastrin, delayed gastric emptying or HP infection. Our study was a randomized clinical trial in which 120 patients with ESRD (Patients who undergo hemodialysis) confirmed HP infection, were divided to four groups having 2-week eradication regimens; Group I: LCA (lansoprazole 30 mg-BD,clarithromycin 250 mg-BD, amoxicillin 500 mg-BD), Group II: LCM (lansoprazole 30 mg-BD,clarithromycin 250 mg-BD, metronidazole 500 mg-BD), Group III: LCAM (lansoprazole 30 mg-BD,clarithromycin 250 mg-BD,amoxicillin 500 mg-BD, metronidazole 500 mg-BD) and Group IV: Sequential (lansoprazole 30 mg-BDfor two weeks; first week: amoxicillin 500 mg-BD and second week: clarithromycin 250 mg-BD, metronidazole 500 mg-BD).6 weeks after treatment, Urea Breath Test (UBT) was performed for all patients. The mean age of patients was 43.1±11.2 years. 55.8% of patients were male. The success rates of HP eradication in 4 groups were76.7%, 70%, 90% and 90%, respectively. HP eradication rates were not statistically different among the regimens (p=0.11). There were not significant differences among the groups regarding demographic and anthropometric variables. The results showed there was no significant difference between the success rates of HP eradication regimens for ESRD patients. According to approved regimen for 90% eradication rate, with a lower number of medications and given the less risk of side effects and drug interactions, the sequential regimen is the best.

The influence of vitamin D deficiency on eradication rates of Helicobacter pylori.

Helicobacter pylori eradication therapy improves the healing of various gastro-duodenal diseases such as chronic gastritis and peptic ulcer, and also reduces gastric cancer incidence. Several studies have reported on risk factors other than antibiotic resistance related to Helicobacter pylori eradication failure. In this study, we aimed to investigate whether or not the serum levels of 25-hydroxy-vitamin D (25(OH)D) influence eradication rates of H.pylori. 220 patients diagnosed with H.pylori gastritis using endoscopic biopsy had their 25-OH vitamin D levels measured via the electrochemiluminescence method before beginning eradication therapy of H.pylori. Gastric biopsies obtained at endoscopy were examined for H.pylori strains and histopathologic findings. All patients were treated with bismuth-containing quadruple therapy for 14 days. H.pylori eradication was determined via the 14C-urea breath test performed 4 weeks after the end of therapy. Based on the 25-OH vitamin D levels, the patients were divided into 2 groups: group 1 (deficient) had a vitamin D level of <10 ng/mL, while group 2 (sufficient) had a vitamin D level of ≥10 ng/ mL. Eradication was successful in 170 (77.2%) patients and failed in 50 (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean 25(OH)D levels were significantly lower in the eradication failure group compared to the successful treatment group (9.13 ±4.7 vs 19.03 ±8.13; p = 0.001). There were significantly more patients with deficient 25(OH)D levels in the failed treatment group compared to the successful treatment group (p = 0.001). Our findings suggest that 25-OH vitamin D deficiency may be considered a risk factor related to eradication failure of H.pylori, which may lead to a need for supplementation of vitamin D before eradication of H.pylori.

Similar Helicobacter pylori Eradication Rate in Obese Patients Undergoing Gastric Bypass Surgery and in General Population

Similar Helicobacter pylori Eradication Rate in Obese Patients Undergoing Gastric Bypass Surgery and in General Population

Cumulative Helicobacter Pylori Eradication Rates by Adopting First- and Second- Line Regimens Proposed by the Maastricht IV Consensus in Obese Patients Undergoing Gastric Bypass Surgery.

Our aim was to assess, in obese patients undergoing Roux-en-Y gastric bypass (RYGB) surgery, the cumulative Helicobacter pylori (HP) eradication rates by adopting Maastricht IV guidelines in areas of high clarithromycin resistance rates (CLT)-14days concomitant first-line therapy with proton-pump inhibitor (PPI) bid, CLT 500mg bid, metronidazole (MTZ) 500 bid, and amoxicillin (AMX) 1000mg bid and 14days second-line therapy with PPI bid, AMX 1000mg bid and levofloxacin (LVF) 500mg od. Single-center prospective study was over 4years. Endoscopy and HP assessment (by histology or C13 urea breath test) were performed at baseline and post-treatment HP status was assessed by C13 urea breath test 4-6weeks after the end of therapy. Seven hundred seventy-seven consecutive HP-positive patients completed concomitant first-line treatment: 636 (81.9%) female, age 41.1 (±10.2) years. HP was eradicated in 556 patients-71.56% (95% CI: 68.28-74.62%). In the remaining 221 patients, second-line LVF-based regimens eradicated HP in 121 patients-54.75% (95% CI: 48.16-61.18%). These results give 87.13% (95% CI: 84.58-89.31%) ITT and 89.43% (95% CI: 87.03-91.44%) PP cumulative eradication rates. Eradication rates were not significantly different by gender, age, endoscopy findings, and smoking habits. By adopting Maastricht IV consensus quadruple concomitant first-line treatment and second-line LVF-based therapy, high cumulative HP eradication rates are achieved but still leaves around 10.6% of obese patients undergoing RYGB in need of the culture and susceptibility testing prior to third-line treatment.

A meta-analysis of randomized controlled trials of bismuth-containing quadruple therapy combined with probiotic supplement for eradication of Helicobacter pylori

Objective: The bismuth containing quadruple therapy (BCQT) acts as first-line therapy in China. Probiotics supplement also shows Helicobacter pylori eradication effects. Adding probiotics along with BCQT may improve eradication rate of Helicobacter pylori. Methods: Electronic databases including Medline, Embase, Wanfang Database, etc. were searched by the established searching strategy. After that, a funnel plot was adopted to evaluate publication bias. The meta-analysis was supplemented in fixed effect model for low heterogeneity and randomized effect model for high heterogeneity conversely. Results: A total of 16 RCTs with 2 466 subjects finally met the inclusion criteria. There was no significant heterogeneity among the trials. Compared with control group (BCQT only), the probiotic group (combined supplement of probiotics and BCQT) underwent higher eradication rate[90.76%(1 130/1 245) vs 80.43%(982/1 221)]with statistical significance (P=0.000). The probiotics might improve the eradication rate in patients not receiving previous eradication therapy [89.00%(445/500) vs 84.73%(416/491), P=0.04]. Probiotics might also improve the eradication rate[91.06%(326/358) vs 73.83%(268/363)]in patients relapsed from triple therapy (P=0.000). The patients who underwent the combination of BCQT and single Lactobacillus genus showed higher eradiation rate than those with two or more genera. Moreover, fewer adverse reactions were reported in probiotics group than that in control group[13.59%(104/765) vs 28.90%(213/737), P=0.000]. Conclusions: The combination of BCQT and probiotics may improve the eradication rate of Helicobacter pylori especially in patients receiving front-line eradication regimen or failed from triple therapy. Probiotics may reduce the adverse reactions when combined with other eradication agents.

Low Eradication Rates of Helicobacter pylori at a Safety Net Hospital

Low Eradication Rates of Helicobacter pylori at a Safety Net Hospital

E‐Poster Presentations – A2) Gastric and Duodenal

E‐Poster Presentations – A2) Gastric and Duodenal

Efficacy and safety of rifaximin associated with standard triple therapy (omeprazole, clarithromycin and amoxicillin) for H. pylori eradication: A phase IV pilot clinical trial

BackgroundA progressive decrease in Helicobacter pylori eradication rates has been described over the years, driving the need for new antibiotic treatments. AimTo evaluate the efficacy and safety of the addition of rifaximin (Spiraxin®) to standard triple therapy (omeprazole, amoxicillin and clarithromycin) for the eradication of H. pylori. MethodsIndependent prospective clinical trial (EUDRACT no.: 2013-001080-23). Forty consecutive adult patients were included with H. pylori infection, dyspeptic symptoms and naive to eradication treatment. A full blood test was performed in the first five patients enrolled to evaluate the safety of the treatment. H. pylori eradication was confirmed with the 13C-urea breath test at least four weeks after the end of treatment with rifaximin 400mg/8h, clarithromycin 500mg/12h, amoxicillin 1g/12h and omeprazole 20mg/12h for 10 days. ResultsForty patients were consecutively enrolled, 53% woman, mean age 44 years. Indication for eradication: 60% non-investigated dyspepsia, 38% functional dyspepsia and 2% gastric ulcer. Four patients did not attend the eradication confirmatory breath test. The eradication rate was 61% (95% CI: 45–77%) for the protocol and 55% (40–70%) for intention-to-treat. About 76% of the patients experienced adverse events (35% diarrhea, 14% nausea and 24% metallic taste), none of which was serious. The blood tests did not show significant alterations. ConclusionAcceptable H. pylori eradication rates are not achieved with rifaximin associated with standard triple therapy for 10 days.

Luminal Clinical

<b>Luminal Clinical</b>

Optimization strategies aimed to increase the efficacy of H.pylori eradication therapies.

As with any other infectious disease, we should aim for treatments offering ≥90% Helicobacter pylori eradication rates in clinical practice. To summarize optimization strategies aimed to increase the efficacy of H.pylori eradication therapies. A systematic bibliographic search (in PubMed up to August 2016) was designed to identify studies investigating optimization strategies aimed to increase the efficacy of H.pylori eradication therapies. The most direct way to optimize a treatment is using higher doses of drugs unless it has been shown that lower doses are equally effective. Similarly, prescriptions should use 14-day duration unless a shorter scheme has been shown locally to be equally effective. Double-dose proton-pump inhibitor therapy is recommended for triple therapy and may probably increase the efficacy of nonbismuth concomitant regimen as well. The efficacy of triple therapies in the presence of resistance can be significantly improved by the addition of bismuth salts, which offer an additive effect in combination with antibiotics. Overall, probiotics seem to reduce antibiotic side effects, but the increase in eradication rates is not so evident; therefore, they cannot be generally recommended for clinical practice yet. Using potent acid inhibition and/or higher antibiotic doses-especially by increasing the number of daily intakes-and lengthening treatments up to 14days improves efficacy in most regimens and should be generally recommended. Triple therapies can be efficiently improved by the addition of bismuth salts, turning them into quadruple therapies. Finally, some treatments will require a combination of optimization strategies to significantly improve results.

Effect of continue nursing care post-discharge on the treatment effectiveness of gastric ulcer in active phase

Objective To investigate the effect of continue nursing care post-discharge on the treatment effectiveness of gastric ulcer in active phase, and to facilitate the nursing quality. Methods A total of 163 patients with gastric ulcer were divided into control group including 80 cases and observation group including 83 cases randomly by hospitalization order. Routine nursing care was administrated on the two groups of patient’s duration of hospital stay equally, but continue nursing care was administrated on the observation group patients exceptionally. The treatment outcome and intervention effect of the two groups were compared at the end of study. Results The overall cure rates of the control the observation group patients were 63.75% (30/80) and 81.93% (68/83), the eradication rates of helicobacter pylori (Hp) were 86.25% (69/80) and 96.39% (80/83), the medication compliance scores of Morisky were 3.69±1.34 and 6.71±1.57, the quality scores of life instruments for chronic were 67.81±7.10 and 86.34±6.83 respectively at the end of follow-up period. There were significant differences in the above indicators (χ2=6.830,5.330, t=13.199,16.977, P<0.05 or 0.01). Kaplan-Meier analysis showed that the cure period of the observation group was significantly shorter than that of the control group (χ2=20.446, P<0.05). Conclusions The continue nursing care post-discharge has positive effect on the treatment of active gastric ulcer, and it should be recommended in clinical application. Key words: Stomach ulcer; Quality of life; Nursing care; Continuity; Medication compliance

Efficacy and safety of Jianzhong decoction in treating peptic ulcers: a meta-analysis of 58 randomised controlled trials with 5192 patients

BackgroundJianzhong decoction is widely used to treat peptic ulcers; however, due to lack of systematic evaluations, its clinical efficacy remains controversial. We performed meta-analysis to evaluate the efficacy and safety of Jianzhong decoction in treating peptic ulcers.MethodsStudies were systematically retrieved from PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, China Biology Medicine disc (CBMdisc), and references cited in related studies/reviews. Extracted data included the total effective rate, helicobacter pylori eradication rates, recurrence rate, and adverse reaction rate. Fifty-eight randomised controlled trials involving 5192 patients were included in the final analysis.ResultsResults showed that Jianzhong decoction therapy was more effective than conventional Western medicine therapy (total effective rate, odds ratio [OR] = 4.29, 95% confidence interval [CI]: 3.51–5.23, P = 0.000; helicobacter pylori eradication rates, OR =2.10, 95% CI: 1.69–2.61, P = 0.000; recurrence rate, OR =0.23, 95% CI: 0.18–0.29, P = 0.000; and adverse reaction rate, OR =0.20, 95% CI: 0.12–0.33, P = 0.000).ConclusionsJianzhong decoction increased the total effective rate and helicobacter pylori eradication rate, and lowered the recurrence and adverse reaction rates. The results of this study can be used as a guide for clinical treatment of peptic ulcers.

Tu1069 - Eradication Rates of Helicobacter Pylori with Levofloxacin Based Triple Therapy in Patients Undergoing Bariatric Surgery

Tu1069 - Eradication Rates of Helicobacter Pylori with Levofloxacin Based Triple Therapy in Patients Undergoing Bariatric Surgery

Triple therapy versus sequential therapy for the first-line Helicobacter pylori eradication

BackgroundThe eradication rate of Helicobacter pylori (H. pylori) with triple therapy which was considered as standard first-line treatment has decreased to 70–85%. The aim of this study is to compare 7-day triple therapy versus 10-day sequential therapy as the first line treatment.MethodsData of 1240 H. pylori positive patients treated with triple therapy or sequential therapy from January 2013 to December 2015 were analyzed retrospectively. The patients who had undertaken previous H. pylori eradication therapy or gastric surgery were excluded.ResultsThere were 872 (74.3%) patients in the triple therapy group, and 302 (25.7%) patients in the sequential therapy group. There was no significant difference between the two groups regarding age, residence, comorbidities or drug compliance, but several differences were noted in endoscopic characteristics and indication for the treatment. The eradication rate of H. pylori by intention to treat analysis was 64.3% in the triple therapy group, and 81.9% in the sequential therapy group (P = 0.001). In per protocol analysis, H. pylori eradication rate in the triple therapy and sequential therapy group was 81.9 and 90.3%, respectively (P = 0.002). There was no significant difference in overall adverse events between the two groups (P = 0.706). For the rescue therapy, bismuth-containing quadruple therapy showed comparable treatment efficacy after sequential therapy, as following triple therapy.ConclusionsThe eradication rate of triple therapy was below the recommended threshold. Sequential therapy could be effective and tolerable candidate for the first-line H. pylori eradication therapy.

Trend in the Eradication Rates of Helicobacter pylori Infection Over the Last 10 Years in West Gyeonggi-do, Korea: A Single Center Experience

The eradication rate of Helicobacter pylori (H. pylori) has been decreasing recently in Korea due to antibiotics resistance. The aim of this study was to investigate the trend of eradication rate and clinical factors affecting the eradication rate of H. pylori in the last 10 years in west Gyeonggi-do, Korea. The trends of eradication rate of H. pylori, gender, age, concomitant mediations, and clinical factors were retrospectively evaluated in patients with H. pylori infection between 2006 and 2015 (n=2,485). The overall H. pylori eradication rate for the standard triple therapy was 82.5%. The annual eradication rates from 2006 to 2015 were 90%, 77.9%, 75.8%, 83.2%, 85.6%, 90.1%, 81.3%, 81.1%, 78.7%, and 78.8%, respectively, showing a significant decrement during the last five years (p<0.001). Higher eradication rate was observed in males than in females (p<0.001). Esomeprazole showed a higher eradication rate compared with pantoprazole between 2006 and 2010 (p<0.022). Age and the use of probiotics and mucosal protective agents played no significant role in the H. pylori eradication rate. The overall eradication rate for bismuth-based quadruple therapy was 94.4%. The eradication rate of H. pylori over the last 10 years for first-line therapy ranged from 75.8 to 90.1%; the eradication rate for triple therapy has declined. However, the eradication rate for quadruple therapy has remained unchanged over the last 10 years.

High and Frequent Dose of Dexlansoprazole and Amoxicillin Dual Therapy for Helicobacter pylori Infections: A Single Arm Prospective Study

Recently, the eradication rate of Helicobacter pylori (H. pylori) infection has decreased to less than 80% worldwide with the use of clarithromycin-based triple therapy owing to the increased resistance of H. pylori to antibiotics, especially clarithromycin and metronidazole. This prospective study aimed to determine eradication rate of H. pylori following high and frequent doses of extended-release dexlansoprazole and amoxicillin, as a dual therapy in a region with high clarithromycin resistance rate. A total of 50 treatment-naïve patients with active H. pylori infections, who were confirmed through via rapid urease test or histology and serology between November 2015 and February 2016 at our hospital, were included for analysis. All enrolled patients were treated with 750 mg amoxicillin and 30 mg dexlansoprazole, four times a day for a total duration of 14 days. Treatment success was determined using urea breath test four weeks after treatment completion. Seven out of the 50 patients (29 men and 21 women; mean age, 57 years) dropped out during the study. The total eradication rate was 52% (26/50), and that for those with a compliance rate of over 90% was 68.4% (26/38). H. pylori infections were not successfully eradicated in patients with a compliance rate of less than 90%. Nine patients (18%) reported side effects, such as mild diarrhea and abdominal fullness. No significant factors, such as smoking and alcohol consumption, affected the infection the eradication rate. High and frequent doses of proton pump inhibitor-amoxicillin dual therapy were not effective in eradicating H. pylori infection in a province with high clarithromycin resistance rate.

Adding Bismuth to Rabeprazole-Based First-Line Triple Therapy Does Not Improve the Eradication of Helicobacter pylori.

This randomized controlled study aimed to evaluate whether adding bismuth to the standard first-line triple therapy could improve the eradication rate of Helicobacter pylori. A total of 162 patients with Helicobacter pylori infection were randomly assigned to either the 7-day triple therapy group (RAK regimen: rabeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg bid; n = 81) or the bismuth plus triple therapy group (n = 81). In the RBAK group, bismuth subcitrate 360 mg twice daily was added to the RAK regimen. A follow-up endoscopy or urea breath test was performed at least 4 weeks after eradication to confirm the treatment efficacy. Comparable compliance and Helicobacter pylori eradication rates were observed in both groups in either intention-to-treat [RAK 72.8% (59/81) versus RBAK 77.8% (63/81); p = 0.47] or per protocol analysis [RAK 74.7% (59/79) versus RBAK 81.8% (63/77); p = 0.26]. Adverse effects were commonly reported (50.6% for both groups) although most of these did not cause cessation of treatment. The resistance rate was 27.2% for metronidazole and 12.3% for clarithromycin. Adding bismuth to the standard 7-day triple therapy did not substantially increase the eradication rate. Further study is needed clarifying whether extending the duration of RBAK regimen to 10–14 days can lead to a better result.

Helicobacter pylori Eradication Rate in Patients with Diabetes

<i>Helicobacter pylori</i> Eradication Rate in Patients with Diabetes

A Comparative Study of a New Class of Gastric Acid Suppressant Agent Named Vonoparazan versus Esomeprazole for the Eradication of Helicobacter pylori

Background:Helicobacter pylori eradication rates have decreased worldwide. Gastric acid inhibition during treatment is important to eradicate these bacteria successfully. A new potassium-competitive acid blocker, vonoprazan (VPZ), has been shown to achieve high eradication rates in a previous randomized controlled trial. Objective: To determine the efficacy of VPZ for H. pylori eradication. Methods: A total of 874 patients were enrolled; 431 received esomeprazole (EPZ) and 443 received VPZ. First-line regimens contained clarithromycin (CAM) 200 mg b.i.d., amoxicillin 750 mg b.i.d., and either EPZ 20 mg b.i.d. or VPZ 20 mg b.i.d. for 7 days. Metronidazole 250 mg b.i.d. replaced CAM in the second-line regimens. The eradication of H. pylori was assessed by ¹³C-urea breath tests 4-8 weeks after each therapy. Results: The overall first-line eradication rate was 79.9% (341/427) with EPZ vs. 86.3% (377/439) with VPZ (p = 0.019). The second-line eradication rate was 83.3% (45/51) with EPZ vs. 91.1% (41/45) with VPZ (p = 0.900). Conclusion: VPZ was significantly more effective than EPZ for first-line treatment. However, for second-line treatment, there was no significant difference between EPZ and VPZ.

Analysis of Helicobacter pylori infection and eradication for adults and children patients with chronic gastritis

Objective To investigate and analyze the infection and eradication of Helicobacter pylori(HP) and its influencing factors for adults and children with chronic gastritis, and to provide a favorable basis for eradication therapy. Methods A total of 856 adult and 920 children with chronic gastritis were investigated by 13c-breath test in terms of infection and eradication of HP, and the self-made questionnaire was collected in terms of the common daily dietary habits. Results The rate of HP infection among patients with chronic gastritis was 60.75% in the adult group and it was 41.74% for the children group, and the rate of HP infection for adults were significantly higher than that of the children's(P<0.01). The following aspects of the HP positive patients of the two groups were higher than that of the HP negative patients(P<0.05), namely sharing the same tableware and toiletries and living with family suffering from HP infection and gastric history and smoking, drinking, spicy food for adults, and sweet, raw food for children. The rate of adverse lifestyle of the adult group was significantly higher than that of the children group (P<0.01) in terms of sharing tableware, smoking, drinking, enjoying spicy diet among the HP positive patients with strict compliance of the doctors HP eradication rate: 69.84% for adult group and 86.20% for children group, adult group were significantly lower than that of the children group(P<0.01). Conclusions The rate of HP infection of the adult group is significantly higher than that of the children group among the patients with chronic gastritis.Common bad diet habits(smoking, drinking, cold and spicy food, sweets, sharing toiletries, sharing tableware and living with persons with HP infection and gastric history) can significantly increase the risk of HP infection, affecting the eradication effect.HP eradication treatment for children is better than of the adult, and the eradication rate is high. Key words: Chronicgastritis; Helicobacter pylori infection; Eradication of Helicobacter pylori; Eating habits