title: Oxidative stress in Helicobacter pylori infection: does supplementation with vitamins C and E increase the eradication rate?
abstract: OBJECTIVE
  This study aims to assess the antioxidant property of vitamins E and C in Helicobacter pylori infection, and to determine if adding them to standard triple therapy plus bismuth subcitrate increases the H. pylori eradication rate.
  
  
  METHODS
  This study included 160 patients infected with H. pylori, who were randomized into one of two groups. Patients in group A (n = 80) received lansoprazole (30 mg, b.i.d.), amoxicillin (1000 mg, b.i.d.), clarithromycin (500 mg, b.i.d.), and bismuth subcitrate (300 mg, q.i.d.) for 14 days, while patients in group B (n = 80) received vitamin C (500 mg, b.i.d.) and vitamin E (200 IU, b.i.d.) for 30 days, in addition to lansoprazole (30 mg, b.i.d.), amoxicillin (1000 mg, b.i.d.), clarithromycin (500 mg, b.i.d.), and bismuth subcitrate (300 mg, q.i.d.) for 14 days. Total antioxidant capacity (TAC) was evaluated with a Randox kit. Success rate was calculated using both intention-to-treat (ITT) and per-protocol (PP) analyses.
  
  
  RESULTS
  One hundred and sixty patients were analyzed using ITT analysis. One hundred and fifty-three patients completed the study. In group A, H. pylori eradication was achieved in 48 (60%) of the 80 patients included in the ITT analysis, and in 48 (64%) of the 75 patients included in the PP analysis. In group B, H. pylori eradication was achieved in 73 (91.25%) of the 80 included in the ITT analysis and in 73 (93.5%) of the 78 patients included in the PP analysis. The eradication rate was significantly higher in group B than in group A (p < .005). TAC was at the lower limit of normal in both groups and the difference between them was not statistically significant (p > .05).
  
  
  CONCLUSIONS
  In group B, H. pylori eradication rate was 91.25%, which is higher than the ideal 80% eradication rate. The results of the present study show that adding the prescribed doses of vitamins E and C to antimicrobial therapy is effective in eradicating H. pylori infection.
authors.affiliation: Department of Gastroenterohepatology, Haydarpaşa Numune Research and Education Hospital, Tibbiye Cad. Usküdar, Istanbul, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Sezikli
authors.forename: Züleyha Akkan
authors.initials: ZA
authors.lastname: Cetinkaya
authors.forename: Hayrünnisa
authors.initials: H
authors.lastname: Sezikli
authors.forename: Fatih
authors.initials: F
authors.lastname: Güzelbulut
authors.forename: Arzu
authors.initials: A
authors.lastname: Tiftikçi
authors.forename: Ali Tüzün
authors.initials: AT
authors.lastname: Ince
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Gökden
authors.forename: Bülent
authors.initials: B
authors.lastname: Yaşar
authors.forename: Sacide
authors.initials: S
authors.lastname: Atalay
authors.forename: Oya Ovünç
authors.initials: OO
authors.lastname: Kurdaş
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000378:metabolism; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D018384:Oxidative Stress / Q000187:drug effects*; D016896:Treatment Outcome; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D009942:Organometallic Compounds; D014810:Vitamin E; C002791:bismuth tripotassium dicitrate; D001205:Ascorbic Acid