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- Title
Helicobacter pylori Eradication Therapy in Obese Patients Undergoing Gastric Bypass Surgery-Fourteen Days Superior to Seven Days?
- Authors
Cerqueira, Rute; Manso, M.; Correia, Manuel; Fernandes, Carolina; Vilar, Hélder; Nora, Mário; Martins, Paulo
- Abstract
Background: The high prevalence of Helicobacter pylori (HP) in our obese population undergoing Roux-en-Y bypass gastric surgery (69.4%) and the concern that it may exacerbate postoperative foregut symptoms and increase gastric cancer risk led us to adopt a policy of HP systematic eradication in this group of patients. Our aim, in obese patients undergoing bypass gastric surgery, was to compare effectivity of 7- and 14-days clarithromycin-based triple therapy as the first-line treatment for HP eradication. Methods: Three hundred seventy-three patients [mean age 41.2 ± 10.3 years; 313 women (83.9%)] were HP positive determined by histology or urea breath test. In 2005, 94 patients (Group A) were treated with a 7-days triple therapy-proton pump inhibitor (PPI) b.i.d., clarithromycin (CL) 500 mg b.i.d., and amoxicillin (AMX) 1,000 mg b.i.d. Since 2006, 279 patients (Group B) were treated with a similar 14-days drug regimen-PPI b.i.d., CL 500 mg b.i.d., and AMX 1,000 mg b.i.d. Posttreatment HP status was assessed by C13 urea breath test 4-6 weeks after the end of therapy. Results: The eradication rates were 67.0% (Group A) and 79.9% (Group B). The eradication rate achieved with 14-days triple therapy was significantly higher than with 7-days triple therapy (OR = 1.96; 95% CI: 1.16-3.30; p = 0.016). Conclusions: A 14-days triple therapy is more effective than 7-days triple therapy suggesting this regimen should be the first-line therapy for HP eradication in Portuguese obese patients undergoing bypass gastric surgery.
- Subjects
HELICOBACTER pylori infections; GASTRIC bypass; BARIATRIC surgery; HISTOLOGY; BREATH tests
- Publication
Obesity Surgery, 2011, Vol 21, Issue 9, p1377
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-010-0254-4