Can 13C urea breath test predict resistance to therapy in Helicobacter pylori infection?
OBJECTIVE
Results of 13C urea breath test (UBT), a noninvasive test for detecting active H. pylori infection, have been regarded also numerically for a possible predictive value on bacterial load and entity of mucosal inflammation. In the present study we wished to determine whether there is a particular value of Delta Over Baseline (DOB) result which could predict resistance to anti-H. pylori therapy.


METHODS
570 subjects from 1376 tested received a standard triple anti-H. pylori regimen. After a minimum of 6 weeks subjects underwent control UBT testing. Correlation of DOB values at diagnostic and control UBT and sensitivity of different DOB levels to predict resistance to therapy were calculated using simple linear correlation and Bayes' theorem, respectively.


RESULTS
Modest linear correlation was observed between DOB values (r2=0.28). The value of 13.0 at diagnostic UBT showed a sensitivity of 65.5% to predict and further positivity at control testing.


CONCLUSIONS
In our large series, UBT numerical DOB value weakly predicted resistance to first-line anti-H. pylori therapy.
Istituto di Medicina Interna e Geriatria, Universita Cattolica del Sacro Cuore, Policlinico Gemelli, Roma, Italia.
Filippo
F
Cremonini
Francesco
F
Bartolozzi
Alessandro
A
Armuzzi
Maria Assunta
MA
Zocco
Luca
L
Santarelli
Maurizio
M
Gabrielli
Marcello
M
Candelli
Enrico C
EC
Nista
Angelo
A
Santoliquido
Antonio
A
Gasbarrini
D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001944:Breath Tests; D002247:Carbon Isotopes / Q000032:analysis; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D011237:Predictive Value of Tests; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000627:therapeutic use; D017211:Treatment Failure; D014508:Urea / Q000032:analysis
D000900:Anti-Bacterial Agents; D002247:Carbon Isotopes; D054328:Proton Pump Inhibitors; D017494:Proton Pumps; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin