Sistema gastrointestinal y digestivo

Abstracto

Primary Helicobacter pylori Eradication Rates of Lansoprazole, Amoxicillin, and Metronidazole Therapy is Much Higher than Lansoprazole, Amoxicillin and Clarithromycin Therapy in Chiba Prefecture, Japan

So Sakamoto, Shunji Fujimori and Fumio Sakamoto

Aim: To compare the efficacy of primary Helicobacter pylori eradication therapy between PPI/AC therapy (proton-pump inhibitor; lansoprazole, amoxicillin, and clarithromycin) and PPI/AM therapy (lansoprazole, amoxicillin, and metronidazole).

Methods: The subjects were patients with Helicobacter pylori infection who received initial eradication treatment at a family doctor in Katori City, Japan. Infection of Helicobacter pylori was initially evaluated pathologically using gastric mucosal specimens obtained by biopsy through upper endoscopy. Ninety-two patients underwent PPI/AC therapy and 28 patients underwent PPI/AM for primary eradication. Success or failure of eradication was determined by a urea breath test, and the primary eradication rates were compared between the two therapies. Patients who underwent PPI/AC but failed to achieve eradication were recommended to undergo secondary eradication treatment with PPI/AM, and the secondary eradication rate was assessed.

Results: In primary eradication therapy, successful eradication rates were 79.3% (73/92) in PPI/AC and 96.4% in PPI/AM, indicating that PPI/AM had a significantly higher eradication success rate (P=0.034). The 19 patients who failed to achieve eradication by PPI/AC underwent secondary eradication by PPI/AM. All 19 cases showed effective eradication (100%). Ultimately, eradication was successful in 99.2% (119/120) patients. Successful eradication rate in the total of primary and secondary PPI/AM treatments was also significantly higher than primary PPI/AC (46/47 vs. 73/92: P=0.007). Neither therapy was associated with any notable side effects.

Conclusion: In this regional study, PPI/AM therapy showed a favorable eradication rate, significantly higher than PPI/AC therapy. Thus, PPI/AM therapy is recommended as the primary eradication therapy in the region.