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Cumulative Helicobacter pylori Eradication Therapy in Obese Patients Undergoing Gastric Bypass Surgery

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Abstract

Background

Our aim was to assess, in obese patients undergoing Roux-en Y gastric bypass surgery, the cumulative Helicobacter pylori (HP) eradication rates in two consecutive time spans (2006–2008 and 2009–2010).

Methods

The study adopted a 14-day clarithromycin-based triple therapy in first-line treatment as proposed by the Maastricht III consensus—proton pump inhibitor bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid—and a 14-day second-line levofloxacin-based empirical regimen—proton pump inhibitor bid, amoxicillin 1,000 mg bid and levofloxacin 500 mg od.

Results

In 2006–2008, 253 patients received first-line therapy. HP was eradicated in 200 patients and 14 patients withdrew (intention to treat (ITT) = 79.1 %; per protocol (PP) = 83.7 %). In the remaining 39 patients, HP was eradicated in 22 patients and 8 patients withdrew (ITT = 56.4 % and PP = 71.0 %). Thus, out of 253 patients, HP was eradicated in 222 patients, 22 patients withdrew and 9 remained positive. In 2009–2010, 437 patients received first-line therapy. HP was eradicated in 256 patients and 30 patients withdrew (ITT = 58.6 %; PP = 62.9 %). In the remaining 151 patients, HP was eradicated in 80 and 6 patients withdrew (ITT = 53.0 % and PP = 55.1 %). These results give cumulative eradication rates of 87.7 % ITT and 96.1 % PP (2006–2008) and of 76.9 % ITT and 83.8 % PP (2009–2010).

Conclusions

Cumulative HP eradication rates have fallen during 2006–2010 due to the fall of first-line eradication therapy rate, which was around 20 %. Therefore, the first-line clarithromycin-based Maastricht III consensus eradication is no longer effective in bariatric patients indicating the need to test new regimens.

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Acknowledgments

The author M.C. Manso acknowledged Fundação para a Ciência e a Tecnologia through grant PEst-C/EQB/LA0006/2011.

Conflicts of Interest

None.

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Authors and Affiliations

  1. Service of Gastroenterology, S. Sebastião Hospital, R Dr. Cândido Pinho, 4520-271, Santa Maria da Feira, Portugal

    Rute M. Cerqueira, Manuel R. Correia, Carolina D. Fernandes & Hélder Vilar

  2. Biostatistics, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal

    M. Conceição Manso

  3. REQUIMTE-UP, Porto, Portugal

    M. Conceição Manso

Authors
  1. Rute M. Cerqueira
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  2. Manuel R. Correia
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  3. Carolina D. Fernandes
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  4. Hélder Vilar
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  5. M. Conceição Manso
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Corresponding author

Correspondence to Rute M. Cerqueira.

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Cerqueira, R.M., Correia, M.R., Fernandes, C.D. et al. Cumulative Helicobacter pylori Eradication Therapy in Obese Patients Undergoing Gastric Bypass Surgery. OBES SURG 23, 145–149 (2013). https://doi.org/10.1007/s11695-012-0747-4

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