High efficacy of bismuth subcitrate for Helicobacter pylori eradication in pangastritis

作者：Severi C^*; Abdullahi M; Tari R; Vannella L; Marcheggiano A; Capoccia D; Leonetti F; O**orn J; Annibale B

来源：Digestive and Liver Disease, 2009, 41(8): 555-558.

DOI：10.1016/j.dld.2008.11.009

• Bismuth
• H. pylori eradication
• Pangastritis
• Proton pump inhibitors

Background: The influence of gastritis patterns in Helicobacter pylon 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 1 g 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.

• 出版日期2009-8