High efficacy of bismuth subcitrate for Helicobacter pylori eradication in pangastritis.
BACKGROUND
The influence of gastritis patterns in Helicobacter pylori eradication rates has been poorly investigated.


OBJECTIVE
To compare the efficacy of bismuth or proton pump inhibitors triple therapy for H. pylori eradication in pangastritis.


METHODS
One hundred and eight patients with pangastritis were assigned to either lansoprazole 30 mg once a day (n=54) or bismuth 240 mg bis in die (n=54) for 14 days combined, for the first week, with amoxicillin 1g plus metronidazole 250 mg tris in die. Eradication was confirmed by (13)C-urea breath test.


RESULTS
With bismuth, successful eradication was observed in 75.9% (41/54) in the intention-to-treat analysis and 78.8% (41/52) in the per-protocol analysis. With lansoprazole, the eradication rates were respectively 46.3% (25/54) and 51.0% (25/49). Bismuth had a significant higher efficacy according to both intention-to-treat analysis (p=0.0029) and per-protocol analysis (p=0.0038) with OR of 3.66 (95% CI: 1.61-8.32) and 3.58 (95% CI: 1.50-8.54) respectively. At regression analysis, the only independent variable affecting eradication was the type of regimen (p=0.026) with an OR of 3.31 (95% CI: 1.16-9.44).


CONCLUSIONS
In pangastritis patients, bismuth is more effective than PPI in first-line eradication. For improving the overall eradication rates, an evaluation of gastritis extent might need to be considered.
Severi
C
C
Gastroenterology Unit, Department of Clinical Sciences, University La Sapienza, Rome, Italy. carola.severi@uniroma1.it
Abdullahi
M
M
Tari
R
R
Vannella
L
L
Marcheggiano
A
A
Capoccia
D
D
Leonetti
F
F
Osborn
J
J
Annibale
B
B
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D055815:Young Adult
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D008795:Metronidazole; D000658:Amoxicillin; C002791:bismuth tripotassium dicitrate