Oxidative stress in Helicobacter pylori infection: does supplementation with vitamins C and E increase the eradication rate?
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.
Sezikli
Mesut
M
Department of Gastroenterohepatology, Haydarpaşa Numune Research and Education Hospital, Tibbiye Cad. Usküdar, Istanbul, Turkey.
Cetinkaya
Züleyha Akkan
ZA
Sezikli
Hayrünnisa
H
Güzelbulut
Fatih
F
Tiftikçi
Arzu
A
Ince
Ali Tüzün
AT
Gökden
Yasemin
Y
Yaşar
Bülent
B
Atalay
Sacide
S
Kurdaş
Oya Ovünç
OO
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*
D000975:Antioxidants; D009942:Organometallic Compounds; D014810:Vitamin E; C002791:bismuth tripotassium dicitrate; D001205:Ascorbic Acid