(HealthDay News) – Geographic site, demographic factors, adherence to initial therapy, and infection recurrence may be as important as the choice of antibiotic regimen in Helicobacter pylori (H. pylori) infection eradication interventions, according to a study published in the Feb. 13 issue of the Journal of the American Medical Association.
To examine the risk of H. pylori recurrence and factors associated with successful eradication, Douglas R. Morgan, MD, MPH, from Vanderbilt University in Nashville, TN, and colleagues randomized 1,463 participants aged 21–65 years from seven Latin American communities to either 14-day lansoprazole, amoxicillin, and clarithromycin (triple); five-day lansoprazole and amoxicillin followed by five-day lansoprazole, clarithromycin, and metronidazole (sequential); or five-day lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant) therapy. Retreatment was offered to those with a positive C-urea breath test (UBT) six to eight weeks after treatment.
The researchers found that, of the 1,091 participants with UBT negative results post-treatment, at one-year follow-up, 125 tested UBT positive, a recurrence risk of 11.5%. The study site, non-adherence to initial therapy, and having children in the household correlated significantly with recurrence. Of the 1,340 participants who had a one-year UBT, negative results were seen for 80.4% in the triple group, 79.8% in the sequential group, and 77.8% in the concomitant group (P=0.61), for an overall effectiveness of 79.3%. Assessing only the single-treatment course, the percentage of UBT-negative results at one year was 72.4%, which correlated significantly with study site, adherence to initial therapy, male sex, and age.
“Our results indicate that geographic site, demographic factors, adherence to initial therapy, and infection recurrence may be as important as the choice of antibiotic regimen in H. pylori eradication interventions,” the authors write.