Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

Giuliana Sereni, Francesco Azzolini, Lorenzo Camellini, Debora Formisano, Francesco Decembrino, Veronica Iori, Cristiana Tioli, Maurizio Cavina, Francesco Di Mario, Giuliano Bedogni, Romano Sassatelli

Research output: Contribution to journalArticle

Abstract

AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test (UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori -positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. "Per protocol" eradication rates for first, second and thirdline therapy were 74.7% (95% CI: 72.7%-76.4%), 85.3% (95% CI: 81.1%-89.1%) and 89.5% (95% CI: 74.9%-103%) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% (95% CI: 97.1%-98.4%), vs 99.9% (95% CI: 99.8%-100%) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P <0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

Original languageEnglish
Pages (from-to)4542-4548
Number of pages7
JournalWorld Journal of Gastroenterology
Volume18
Issue number33
DOIs
Publication statusPublished - 2012

Fingerprint

Helicobacter Infections
Helicobacter pylori
Amoxicillin
Breath Tests
Proton Pump Inhibitors
Therapeutics
Tinidazole
Urea
Clarithromycin
Levofloxacin
Duodenal Ulcer
Ulcer
Habits
Stomach
Histology
Smoking

Keywords

  • Eradication rate
  • Eradication treatment
  • Firstline therapy
  • Helicobacter pylori
  • Rescue therapy
  • Second-line therapy
  • Triple therapy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection. / Sereni, Giuliana; Azzolini, Francesco; Camellini, Lorenzo; Formisano, Debora; Decembrino, Francesco; Iori, Veronica; Tioli, Cristiana; Cavina, Maurizio; Di Mario, Francesco; Bedogni, Giuliano; Sassatelli, Romano.

In: World Journal of Gastroenterology, Vol. 18, No. 33, 2012, p. 4542-4548.

Research output: Contribution to journalArticle

Sereni, G, Azzolini, F, Camellini, L, Formisano, D, Decembrino, F, Iori, V, Tioli, C, Cavina, M, Di Mario, F, Bedogni, G & Sassatelli, R 2012, 'Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection', World Journal of Gastroenterology, vol. 18, no. 33, pp. 4542-4548. https://doi.org/10.3748/wjg.v18.i33.4542
Sereni, Giuliana ; Azzolini, Francesco ; Camellini, Lorenzo ; Formisano, Debora ; Decembrino, Francesco ; Iori, Veronica ; Tioli, Cristiana ; Cavina, Maurizio ; Di Mario, Francesco ; Bedogni, Giuliano ; Sassatelli, Romano. / Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 33. pp. 4542-4548.
@article{20f61dcbe45f4d93b38ed2e13802a616,
title = "Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection",
abstract = "AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test (UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori -positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. {"}Per protocol{"} eradication rates for first, second and thirdline therapy were 74.7{\%} (95{\%} CI: 72.7{\%}-76.4{\%}), 85.3{\%} (95{\%} CI: 81.1{\%}-89.1{\%}) and 89.5{\%} (95{\%} CI: 74.9{\%}-103{\%}) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8{\%} (95{\%} CI: 97.1{\%}-98.4{\%}), vs 99.9{\%} (95{\%} CI: 99.8{\%}-100{\%}) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P <0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.",
keywords = "Eradication rate, Eradication treatment, Firstline therapy, Helicobacter pylori, Rescue therapy, Second-line therapy, Triple therapy",
author = "Giuliana Sereni and Francesco Azzolini and Lorenzo Camellini and Debora Formisano and Francesco Decembrino and Veronica Iori and Cristiana Tioli and Maurizio Cavina and {Di Mario}, Francesco and Giuliano Bedogni and Romano Sassatelli",
year = "2012",
doi = "10.3748/wjg.v18.i33.4542",
language = "English",
volume = "18",
pages = "4542--4548",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "33",

}

TY - JOUR

T1 - Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

AU - Sereni, Giuliana

AU - Azzolini, Francesco

AU - Camellini, Lorenzo

AU - Formisano, Debora

AU - Decembrino, Francesco

AU - Iori, Veronica

AU - Tioli, Cristiana

AU - Cavina, Maurizio

AU - Di Mario, Francesco

AU - Bedogni, Giuliano

AU - Sassatelli, Romano

PY - 2012

Y1 - 2012

N2 - AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test (UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori -positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. "Per protocol" eradication rates for first, second and thirdline therapy were 74.7% (95% CI: 72.7%-76.4%), 85.3% (95% CI: 81.1%-89.1%) and 89.5% (95% CI: 74.9%-103%) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% (95% CI: 97.1%-98.4%), vs 99.9% (95% CI: 99.8%-100%) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P <0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

AB - AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test (UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori -positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. "Per protocol" eradication rates for first, second and thirdline therapy were 74.7% (95% CI: 72.7%-76.4%), 85.3% (95% CI: 81.1%-89.1%) and 89.5% (95% CI: 74.9%-103%) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% (95% CI: 97.1%-98.4%), vs 99.9% (95% CI: 99.8%-100%) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P <0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

KW - Eradication rate

KW - Eradication treatment

KW - Firstline therapy

KW - Helicobacter pylori

KW - Rescue therapy

KW - Second-line therapy

KW - Triple therapy

UR - http://www.scopus.com/inward/record.url?scp=84867721936&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867721936&partnerID=8YFLogxK

U2 - 10.3748/wjg.v18.i33.4542

DO - 10.3748/wjg.v18.i33.4542

M3 - Article

C2 - 22969227

AN - SCOPUS:84867721936

VL - 18

SP - 4542

EP - 4548

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 33

ER -