Eradication Rate and Risk Factors of First Line Treatment Failure in H-Pylori Infected Patients

Background: There is high prevalence of H-pylori infection, 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, concomitant 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 eradication 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.