Predictors of failure of Helicobacter pylori eradication with the standard 'Maastricht triple therapy'

F. Perri, M. R. Villani, V. Festa, M. Quitadamo, A. Andriulli

Research output: Contribution to journalArticle

Abstract

Background: Triple therapy with proton pump inhibitor, clarithromycin and amoxicillin has recently been proposed in Maastricht as first-line treatment for H. pylori infection. Aim: To determine predictors of unsuccessful eradication. Methods: Two hundred and forty-eight patients underwent endoscopy with biopsies for rapid urease test, histology and culture with antibiotic susceptibility tests, and 13C-UBT. All infected patients were given pantoprazole (40 mg b.d.), clarithromycin (500 mg b.d.) and amoxicillin (1 g b.d.) for 1 week. Eradication was assessed by UBT at 4-6 weeks after therapy. Results: One hundred and sixty-two of 248 patients (65%) were infected. Culture was positive in 144 (89%). Prevalence rates of metronidazole, clarithromycin and amoxicillin resistance were 14, 8 and 3%. respectively. Eradication rates (95% CI) were 63% (54.7-70.6) by intention-to-treat analysis and 67% (59.4-75.4) by per protocol analysis. Drug compliance was excellent and side-effects were mild. Age ≥ 45 years (OR: 2.35, CI: 1.30-4.25). smoking (OR: 1.37, CI 1.01-1.87) and high pre-treatment UBT results (OR: 1.36, CI: 1.08-1.72) were independent predictors of eradication failure. Gender, endoscopic findings, alcohol intake, and clarithromycin and amoxicillin resistance did not predict treatment failure. Conclusion: Despite the low prevalence of primary antibiotic resistance in our geographical area, triple therapy with pantoprazole, amoxicillin and clarithromycin achieves low eradication rates. Smoking, age and pre-treatment UBT results are predictors of potential eradication failure.

Original languageEnglish
Pages (from-to)1023-1029
Number of pages7
JournalAlimentary Pharmacology and Therapeutics
Volume15
Issue number7
DOIs
Publication statusPublished - 2001

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ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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