Abstract
Helicobacter pylori (Hp) infection is highly prevalent in many countries and may cause gastritis, peptic ulcer disease, gastric cancer, and lymphoma. Successful eradication depends on the specific treatment used, patient compliance, and Hp antibiotic resistance. The primary aim was to characterize groups of patients with one or more failures of Hp eradication treatment. The secondary aim was to evaluate the factors that influence eradication failure. Between April 1, 1998, and December 31, 2001, 5885 patients were studied for the success of Hp eradication with the 13C-urea breath test (13C-UBT): 5442 after one course of treatment (Group I), 380 after two courses (Group II), and 63 after three courses (Group III). The 13C-UBT was positive in 27.8%, 37.4%, and 47.6% of patients in Groups I, II, and III, respectively (PI-II = 0.000, PII-III = 0.126). A combination of omeprazole, amoxicillin, and clarithromycin (OAC) was used in 31.3%, 27.4%, and 7.9% of Groups I, II, and III, respectively, and a combination of omeprazole, amoxicillin, and metronidazole (OAM) in 15.2%, 28.9%, and 28.6%, respectively. Regimens that contained clarithromycin were used in decreasing order in Groups I, II, and III, and regimens containing metronidazole, bismuth, or tetracycline, in increasing order. The only good prognostic factor for successful eradication was Israeli origin, while European–American and Asian–African origin, recurrence of symptoms, a history of duodenal ulcer, and chronic proton pump inhibitor (PPI) use did not favor successful eradication. Our results suggest that origin, history of peptic disease, and chronic PPI use are predictors of eradication failure.
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References
Everhart JE: Recent developments in the epidemiology of Helicobacter pylori. Gastroenterol Clin North Am 29:559–578, 2000
Williams MP, Pounder RE: Helicobacter pylori: from the benign to the malignant. Am J Gastroenterol 94 (Suppl):s11–s16, 1999
Savarino V, Vigneri S, Celle G: The 13C urea breath test in the diagnosis of Helicobacter pylori infection. Gut 45 (Suppl 1):118–122, 1999
Novis BH, Gabay G, Naftali T: Helicobacter pylori: the Middle East scenario. Yale J Biol Med 71:135–141, 1998
Samra Z, Shmueli H, Niv Y, Dinari G, Ofek I, Passaro DJ, Geler A, Gal E. Fishman M, Bachor J, Yahav J: Resistance of Helicobactor pylori isolates in Israel to metronidazole, Clarithromytcin, tetracycline, amoxicillin and cefoxime. J Antimicrob Chemother 46:1023–1026, 2002
Logan RP: Urea breath tests in the management of Helicobacter pylori infection. Gut 43 (Suppl 1):s47–s50, 1998
Perri F, Clemente R, Pastore M, Quitadamo M, Festa V, Bisceglia M, Li Bergoli M, Lauriola G, Leandro G, Ghoos Y, Rutgeerts P, Andriulli A: The 13C urea breath test as a predictor of intragastric bacterial load and severity of Helicobacter pylori gastritis. Scand J Clin Lab Invest 58:19–27, 1998
Sheu BS, Lee SC, Yang HB, Lin XZ: Quantitative results of 13C urea breath test at 15 minutes may correlate with the bacterial density of H. pylori in the stomach. Hepatogastroenterology 46:2057–2062, 1999
Hawtin PR: Serology and urea breath test in the diagnosis of H. pylori infection. Mol Biotechnol 11:85–92, 1999
Cutler AF, Prasad VM: Long term follow-up of Helicobacter pylori serology after successful eradication. Am J Gastroenterol91:85–88, 1996
Perez-Perz GI, Culter AF, Blaser MJ: Value of serology as a noninvasive method for evaluating the efficacy of treatment of Helicobacter pylori infection. Clin Infect Dis 25:1038–1043, 1997
Peterson WL, Graham DY: Helicobacter pylori. In Sleisenger & Fordtran’s Gastrointestinal and Liver Disease, 6th ed. W. B. Saunders, Philadelphia, 1998, pp 604–619
Malfertheiner P, Megraud F, O’Morain C, Hungin APS, Jones R, Axon A, Graham DY, Tytgat G: The European Helicobacter Study Group, Maastricht II, 2000. Aliment Pharmacol Ther16:167–180, 2001
McColl K, Murray L, El-Omar E, Dickson A, El-Nujumi A, Wirz A, Kelman A, Penny C, Knill-Jones R, Hilditch T: Symptomatic benefit from eradicating Helicobacter pyloriinfection in patients with nonulcer dyspepsia. N Engl J Med 339:1869–1874, 1998
Annibale B, D’Ambra G, Luzzi I, Marcheggiano A, Lannoni C, Paoletti M, Anania MC, Marignani M, Dell Fave G: Does pretreatment with omeprazole decrease the chance of eradication of Helicobacter pylori in peptic ulcer patients? Am J Gastroenterol 92:790–794, 1997
Moayyedi P, Chalmers DM, Axon AT: Patient factors that predict failure of omeprazole, clarithromycin, and tinidazole to eradicate Helicobacter pylori. J Gastroenterol 32:24–27, 1997
Perri F, Villani MR, Festa V, Quitadamo M, Andriulli A: Predictors of failure of Helicobacter pylori eradication with the standard “Maastricht triple therapy.” Aliment Pharmacol Ther 15:1023–1029, 2001
Fireman Z, Segal A, Moshkowitz M, Kopelman Y, Sterenberg A: Helicobacter pylori and peptic disease therapies: a survey of gastroenterologists in Israel. Helicobacter 3:93–96, 1998
Avidan B, Weiss B, Chowers Y, Younash A, Bar-Meir S, Keler N: Sensitivity and resistance of Helicobacter pylori to antibiotic treatment. Harefuah 137:272–274, 1999
Weisfeld AS, Simmons DE, Vance PH: In vitro susceptibility of pre-treatment isolates of Helicobacter pylori from the multicenter United States clinical trials. Gastroenterology 110:A295, 1996 (abstr)
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Niv, Y., Koren, R. 13C-Urea Breath Test for Success of Helicobacter pylori Eradication: Study of 5885 Israeli Patients.. Dig Dis Sci 50, 1513–1516 (2005). https://doi.org/10.1007/s10620-005-2870-8
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DOI: https://doi.org/10.1007/s10620-005-2870-8