title: How Effective Is the Quadruple Concomitant Helicobacter Pylori Eradication Therapy for Obese Patients Undergoing Gastric Bypass Surgery?
abstract: Our aim was to assess, in obese patients undergoing Roux-en Y gastric bypass surgery, the quadruple concomitant HP eradication rates at first line treatment as proposed by the Maastricht IV consensus in areas of high clarithromycin resistance rates-proton pump inhibitor bid, clarithromycin 500 mg bid, amoxicillin 1000 mg bid, and metronidazole 500 mg bid. This is a single center prospective study over a 3-year period. Endoscopy and HP assessment (by histology or C13 urea breath) were performed at baseline, and post treatment HP status was assessed by C13 urea breath test 4-6 weeks after the end of therapy.
  
  
  
  The study cohort consisted of 600 adult obese HP positive patients [19 % male/81 % female, age 40.7 (±10.4) years] consecutively scheduled for HP concomitant therapy. HP was eradicated in 416 patients [69.3 % (95% CI 65.5-72.9 %)] and the eradication was independent of gender, age, endoscopic diagnosis, and smoking status (p > 0.05).
  
  
  
  Two weeks quadruple concomitant therapy did not achieve Maastricht recommended first line acceptable HP eradication rates (at least 80 %) in obese Portuguese patients undergoing GB.
authors.affiliation: Gastroenterology, Centro Hospitalar entre Douro e Vouga, Santa Maria Feira, Portugal. rute.cerqueira@chedv.min-saude.pt.
authors.forename: Rute M
authors.initials: RM
authors.lastname: Cerqueira
authors.affiliation: Gastroenterology, Centro Hospitalar entre Douro e Vouga, Santa Maria Feira, Portugal.
authors.forename: Manuel R
authors.initials: MR
authors.lastname: Correia
authors.affiliation: Gastroenterology, Centro Hospitalar entre Douro e Vouga, Santa Maria Feira, Portugal.
authors.forename: Hélder
authors.initials: H
authors.lastname: Vilar
authors.affiliation: Biostatistics, Faculty of Health Sciences, FP-ENAS, University Fernando Pessoa, Porto, Portugal.|LAQV@REQUIMTE-UP, Porto, Portugal.
authors.forename: M Conceição
authors.initials: MC
authors.lastname: Manso
mesh_terms: D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D015390:Gastric Bypass; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011174:Portugal; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Bariatric surgery; Concomitant therapy; Helicobacter pylori infection; Obesity