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High efficacy of bismuth subcitrate for Helicobacter pylori eradication in pangastritis.

Author(s): Severi C, Abdullahi M, Tari R, Vannella L, Marcheggiano A, Capoccia D, Leonetti F, Osborn J, Annibale B

Affiliation(s): Gastroenterology Unit, Department of Clinical Sciences, University La Sapienza, Rome, Italy. carola.severi@uniroma1.it

Publication date & source: 2009-08, Dig Liver Dis., 41(8):555-8.

Publication type: Randomized Controlled Trial

BACKGROUND: The influence of gastritis patterns in Helicobacter pylori eradication rates has been poorly investigated. AIMS: To compare the efficacy of bismuth or proton pump inhibitors triple therapy for H. pylori eradication in pangastritis. PATIENTS AND 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.

Page last updated: 2009-10-20

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