Eradication Rate and Risk Factors of First Line Treatment Failure in H-Pylori Infected Patients
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- Category: Vol. 81, March 2013
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Eradication Rate and Risk Factors of First Line Treatment Failure in H-Pylori Infected Patients,AHMED FAISAL, MOHAMED MOSAAD and ABDEL NASER GADALLAH
Abstract
Background: There is high prevalence of H-pylori infec-tion, among population with highly variability of Eradication rate in different communities, the eradication rate and risk factors associated with treatment failure are poorly understood.
Subjects and Methods: One hundred twelve consecutive H-pylori infected patients, who were diagnosed by C urea breath test, selected and subjected to history taking, clinical assessment and some laboratory investigationsto define some risk factors like demographic data, ethnicity, smoking, con-comitant NSAID, BMI, CRP, and comorbidity which could be associated with treatment failure. All patients received triple therapy (clarithromycin 500mg+metronidazole 500mg for 10 days+pantoprazole 40mg for 21 days) as first line treatment, Two months, later C urea breath test was done to define the eradication rate, the positive patients received second line treatment.
Results: The mean age was in the fourth decade, men and women were equally represented. Most of them were Arabic and saudian, 12.5% were smokers, most of the partners of married patients (64%) has infection by H-pylori. The eradi-cation rate in triple therapy group was 41.3% (95% CI 84.5- 99.5%), while was 59.8% in the second line treatment group (95% CI 86.6-100%). The only significant risk factor for failure to resolve Helicobacter pylori infection 2 months after initiation of triple therapy is the presence of the infection in the patient spouse (RR=2.0, CI is between 1.45 and 2.76).
Conclusion: Triple therapy as first line treatment in H-pylori infection, should be reviewed, as eradication rate is less than 50%. Testing and treatment of the family, and specially the partner of married patients could be an important step in improvement of H-pylori treatment success.