Risk factors associated withHelicobacter pyloriinfection treatment failure in a high prevalence area

Abstract

SUMMARYTriple therapy is commonly used for the treatment ofHelicobacter pyloriinfection. We determined risk factors associated with its failure in compliant patients focusing onH. pyloridensity, virulence marker and 23S ribosomal RNA (rRNA) point mutations associated with clarithromycin resistance.H. pyloriinfection was diagnosed by14C urea breath test (14C UBT) and rapid urease test or histology. Triple therapy with esomeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. was prescribed for 10 days.14C UBT was repeated 4 weeks after treatment. In total, 111 patients [69 (62%) males] with a mean age of 46±16 years were enrolled. The mean age of treatment failure was 39±14 years compared to 48±16 years with eradication (P=0·002). Treatment failure was associated with younger mean age, point mutations in the23S rRNAgene ofH. pyloriandvacA s1aandm1when associated withcagAnegativity.