Greater Than 95% Success with 14-day Bismuth Quadruple Anti-Helicobacter pylori Therapy: A Pilot Study in US Hispanics
Salazar CO et al. – The pilot study supports the concept that 14–day OBMT therapy is likely to be more efficacious for H. pylori eradication (Grade A, PP basis) than a 10–day course where metronidazole resistance is suspected. If confirmed, 14 days should be recommended in populations where metronidazole resistance is common.Methods
- A one-arm, open-label pilot study of H. pylori-infected, asymptomatic/mildly dyspeptic adults, Hispanic residents of El Paso, Texas, received a 14-day course of omeprazole, plus the combination capsule.
- The authors cultured and Gram-stained specimens obtained using a minimally invasive orogastric brush.
- Helicobacter pylori status was determined by 13C-urea breath test at 4 or more weeks post-therapy.
- Forty-seven subjects (7 men and 40 women, average age 42 years) were entered.
- The per-protocol effectiveness was 97.1% (33/34) (95% mid-P CI: 86.3, 99.9); 100% of metronidazole-resistant strains were eradicated.
- Side effects were mild and self-limited but contributed to nonadherence.
- Therapy taken for <10 days was more likely to result in eradication failure (p < .001).
- Office-based orogastric brushing was well tolerated; positive cultures were obtained in 95%.
- Gram staining showed H. pylori-like forms in all specimens.