Short-term outcomes and intermediate-term follow-up of Helicobacter pylori infection treatment for naïve patients: a retrospective observational study

Abstract

Objectives: To explore the outcomes of Helicobacter pylori infection treatments for naïve patients in the real-world settings.

Design: A retrospective observational study.

Setting: Single tertiary level academic hospital in China.

Participants: We identified patients initially receiving quadruple therapy for H. pylori infection from 2017 to 2020 in whom eradication was confirmed (n=23 470).

Primary outcome: Efficacy of different initial H. pylori infection treatments.

Secondary outcome: Results of urea breath test (UBT) after H. pylori eradication.

Results: Among 23 470 patients who received initial H. pylori treatment, 21 285 (90.7%) were treated with amoxicillin-based regimens. The median age of the patients decreased from 2017 to 2020 (45.0 vs 39.0, p<0.0001). The main treatments were therapies containing amoxicillin and furazolidone, which had an eradication rate of 87.6% (14 707/16 784); those containing amoxicillin and clarithromycin had an eradication rate of 85.5% (3577/4182). The date of treatment, age, antibiotic regimen and duration of treatment showed correlations with the failure of H. pylori eradication in a multivariable logistic regression analysis. Finally, positive UBT results after eradication clustered around the cut-off value, in both the ¹³C-UBT and ¹⁴C-UBT.

Conclusions: The major H. pylori infection treatments for naïve patients were those containing amoxicillin and furazolidone, which offered the highest eradication rate. The date of treatment, age, antibiotic regimen and duration of treatment were risk factors for the failure of H. pylori eradication. Additionally, positive UBT results after eradication clustered around the cut-off value.

Keywords: diagnostic microbiology; gastroduodenal disease; gastrointestinal infections; infectious diseases.