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. 1995 Jun;36(6):845–847. doi: 10.1136/gut.36.6.845

High Helicobacter pylori numbers are associated with low eradication rate after triple therapy.

M Moshkowitz 1, F M Konikoff 1, Y Peled 1, M Santo 1, A Hallak 1, Y Bujanover 1, E Tiomny 1, T Gilat 1
PMCID: PMC1382620  PMID: 7615271

Abstract

This study tested the influence of pretreatment bacterial density on the eradication rate of Helicobacter pylori with triple therapy. One hundred and thirty two patients with endoscopically confirmed H pylori positive, duodenal ulcer or antral gastritis were treated with triple therapy (colloidal bismuth/metronidazole/amoxicillin) for two weeks. Pretreatment urease activity was assessed by the 14C-urea breath test (UBT) in all patients. The mean (SD) pretreatment UBT concentration was similar in patients with duodenal ulcers (318.4 (175.0)) and patients with antral gastritis (288.9 (165.5)). Overall eradication of H pylori was achieved in 85 of 132 patients (64.4%), but was significantly different between patients with high, intermediate, or low pretreatment urease activity (37.5%, 69.5%, and 87.8% respectively). The mean post-treatment UBT value of patients in whom eradication failed was in direct correlation with the pretreatment UBT values. In conclusion, bacterial density, as assessed by urease activity, is an important factor in predicting H pylori eradication. It is suggested that the pretreatment UBT has the potential to identify patients who require modification of the standard therapeutic regimen.

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Selected References

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  1. Atherton J. C., Spiller R. C. The urea breath test for Helicobacter pylori. Gut. 1994 Jun;35(6):723–725. doi: 10.1136/gut.35.6.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Axon A. R. Duodenal ulcer: the villain unmasked? BMJ. 1991 Apr 20;302(6782):919–921. doi: 10.1136/bmj.302.6782.919. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chiba N., Rao B. V., Rademaker J. W., Hunt R. H. Meta-analysis of the efficacy of antibiotic therapy in eradicating Helicobacter pylori. Am J Gastroenterol. 1992 Dec;87(12):1716–1727. [PubMed] [Google Scholar]
  4. Davies M. H., Elias E., Acharya S., Cotton W., Faulder G. C., Fryer A. A., Strange R. C. GSTM1 null polymorphism at the glutathione S-transferase M1 locus: phenotype and genotype studies in patients with primary biliary cirrhosis. Gut. 1993 Apr;34(4):549–553. doi: 10.1136/gut.34.4.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Glupczynski Y., Burette A., De Koster E., Nyst J. F., Deltenre M., Cadranel S., Bourdeaux L., De Vos D. Metronidazole resistance in Helicobacter pylori. Lancet. 1990 Apr 21;335(8695):976–977. doi: 10.1016/0140-6736(90)91043-a. [DOI] [PubMed] [Google Scholar]
  6. Glupczynski Y., Burette A. Drug therapy for Helicobacter pylori infection: problems and pitfalls. Am J Gastroenterol. 1990 Dec;85(12):1545–1551. [PubMed] [Google Scholar]
  7. Graham D. Y. Campylobacter pylori and peptic ulcer disease. Gastroenterology. 1989 Feb;96(2 Pt 2 Suppl):615–625. doi: 10.1016/s0016-5085(89)80057-5. [DOI] [PubMed] [Google Scholar]
  8. Graham D. Y., Lew G. M., Malaty H. M., Evans D. G., Evans D. J., Jr, Klein P. D., Alpert L. C., Genta R. M. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology. 1992 Feb;102(2):493–496. doi: 10.1016/0016-5085(92)90095-g. [DOI] [PubMed] [Google Scholar]
  9. Hui W. M., Ho J., Lam S. K. Pathogenetic role of Helicobacter pylori in duodenal ulcer disease. Multivariate analysis of factors affecting relapse. Dig Dis Sci. 1991 Apr;36(4):424–430. doi: 10.1007/BF01298869. [DOI] [PubMed] [Google Scholar]
  10. Logan R. P., Gummett P. A., Misiewicz J. J., Karim Q. N., Walker M. M., Baron J. H. One week eradication regimen for Helicobacter pylori. Lancet. 1991 Nov 16;338(8777):1249–1252. doi: 10.1016/0140-6736(91)92111-e. [DOI] [PubMed] [Google Scholar]
  11. Logan R. P., Gummett P. A., Misiewicz J. J., Karim Q. N., Walker M. M., Baron J. H. One week's anti-Helicobacter pylori treatment for duodenal ulcer. Gut. 1994 Jan;35(1):15–18. doi: 10.1136/gut.35.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Marshall B. J., Goodwin C. S., Warren J. R., Murray R., Blincow E. D., Blackbourn S. J., Phillips M., Waters T. E., Sanderson C. R. Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet. 1988 Dec 24;2(8626-8627):1437–1442. doi: 10.1016/s0140-6736(88)90929-4. [DOI] [PubMed] [Google Scholar]
  13. Moshkowitz M., Peled Y., Baratz M., Halpern Z., Tiomny E., Gilat T. 14C-urea breath test--a simple, noninvasive method for the detection of Helicobacter pylori infection. Isr J Med Sci. 1993 Feb-Mar;29(2-3):94–97. [PubMed] [Google Scholar]
  14. Moshkowitz M., Santo M., Hallak A., Arber N., Tiomny E., Peled Y., Gorea A., Gilat T. [Antimicrobial sensitivity and treatment of Helicobacter pylori infections]. Harefuah. 1994 Feb 1;126(3):126-8, 176, 175. [PubMed] [Google Scholar]
  15. Peterson W. L., Graham D. Y., Marshall B., Blaser M. J., Genta R. M., Klein P. D., Stratton C. W., Drnec J., Prokocimer P., Siepman N. Clarithromycin as monotherapy for eradication of Helicobacter pylori: a randomized, double-blind trial. Am J Gastroenterol. 1993 Nov;88(11):1860–1864. [PubMed] [Google Scholar]
  16. Peterson W. L. Helicobacter pylori and peptic ulcer disease. N Engl J Med. 1991 Apr 11;324(15):1043–1048. doi: 10.1056/NEJM199104113241507. [DOI] [PubMed] [Google Scholar]
  17. Rauws E. A., Royen E. A., Langenberg W., Woensel J. V., Vrij A. A., Tytgat G. N. 14C-urea breath test in C pylori gastritis. Gut. 1989 Jun;30(6):798–803. doi: 10.1136/gut.30.6.798. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Rauws E. A., Tytgat G. N. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet. 1990 May 26;335(8700):1233–1235. doi: 10.1016/0140-6736(90)91301-p. [DOI] [PubMed] [Google Scholar]

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