Patient Factors Affecting Helicobacter Pylori Eradication Therapy
摘要
Various regimes effectively eradicate Helicobacter pylori (H. pylori) in infected peptic ulcer patients. Few of them reveal perfect outcomes. Several factors are reported to be associated with the success of the eradication therapy. In order to elucidate potential influencing patient factors of H. pylori eradication therapy in Taiwan, 111 H. pylori-associated peptic ulcer patients with excellent compliance (drugs consumption greater than 95%) were recruited. Potential factors were collected by telephone interview and medical record review. Variables analyzed included age, gender, past history of peptic ulcer disease, ulcer location, habits of cigarette smoking, alcohol drinking, pretreatment with proton-pump inhibitors or histamine-2 receptor antagonists and history of diabetes or hypertension. H. pylori status was determined by rapid urease test and modified Giemsa’s staining histology in endoscopically biospsied specimen while (superscript 13)C-urea breath test was further added in post-treatment determination. 104 patients responded and were included in this analysis; 70% of them were treated with ranitidine-based regimes. Regardless of ranitidine-based or omeprozole-based regimes, no significantly affecting factors could be found except for different treatment groups in univariate analysis; in addition, no significant variables were selected in multiple logistic regression model controlling treatment groups. Ranitidine plus amoxicillin dual therapy eradicated H. pylori less effectively (P＜0.001). 52.9% of the patients were treated with metronidazole-containing regimes with 8 failure cases. Metronidazole-resistance was not assessed due to no culture data available in this series. This analysis suggests the importance of selecting efficient regimes and that, excluding compliance, no patient factors significantly affected the outcomes of H. pylori eradication therapy.