Korean J Gastroenterol.  2020 Sep;76(3):142-149. 10.4166/kjg.2020.76.3.142.

Efficacy of Seven-day High-dose Esomeprazole-based Triple Therapy versus Seven-day Standard Dose Non-esomeprazole-based Triple Therapy as the First-line Treatment of Patients with Helicobacter pylori Infection

• Lee YD
• Kim SE
• Park SJ
• Park MI
• Moon W
• Kim JH
• Jung K
• Song J

• KMID: 2506670
• DOI: http://doi.org/10.4166/kjg.2020.76.3.142

Abstract

Background/Aims
The rates of Helicobacter pylori (H. pylori) eradication have declined with the use of proton pump inhibitor-amoxicillin-clarithromycin as the first-line triple therapy. On the other hand, several studies have suggested that high gastric pH levels could affect the H. pylori eradication rate by enhancing the efficacy of antimicrobials. This study compared the efficacy of seven-day high-dose esomeprazole-based triple therapy (7-HEAC) for first-line H. pylori eradication with the seven-day standard dose non-esomeprazole-based triple therapy (7-NEAC) to identify the risk factors related to eradication failure.
Methods
This study included 223 patients who were diagnosed with a H. pylori infection and received 7-HEAC or 7-NEAC between June 2016 and January 2017. The H. pylori eradication rates, as well as demographic and clinical factors, were investigated retrospectively. H. pylori eradication was confirmed by a ¹³C-urea breath test or rapid urease test at least 4 weeks after the completion of therapy.
Results
The eradication rates were 67.7% (105/155; 95% CI 59.5-74.8%) in the 7-NEAC group and 80.9% (55/68; 95% CI 69.9-89.8%) in the 7-HEAC group (p=0.045). The adverse event rates were 5.8% (9/155) in the 7-NEAC group and 7.4% (5/68) in the 7-HEAC group (p=0.661). Multivariate analysis revealed being female (OR 2.08; 95% CI 1.15-3.76) to be associated with the failure of H. pylori eradication therapy.
Conclusions
The eradication rate of the 7-HEAC group was higher than that of the 7-NEAC group. Nevertheless, more effective first-line therapies may be necessary for H. pylori eradication in the near future.

Keyword

Helicobacter pylori; Disease eradication; Esomeprazole; Proton pump inhibitors

Figure

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  Fig. 1 Helicobacter pylori eradication rates of 7-HEAC and 7-NEAC (p=0.045). 7-NEAC, 7-day standard dose non-esomeprazole-based triple therapy; 7-HEAC, 7-day high-dose esomeprazole-based triple therapy.

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