Open AccessClinical characterization of Helicobacter pylori infected patients 15 years after unsuccessful eradication
Author(s) -
Oddmund Nestegard,
Knut Johnsen,
Sveinung Wergeland Sørbye,
FredArne Halvorsen,
Tor Inge Tønnessen,
Eyvind J. Paulssen,
K Melby,
Rasmus Goll,
Jon Florholmen
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0238944
Subject(s) - medicine , helicobacter pylori , gastroenterology , levofloxacin , amoxicillin , cohort , regimen , proton pump inhibitor , antibiotics , biology , microbiology and biotechnology
Background and aims Patients that have failed therapy for Helicobacter pylori ( H . pylori ) infection are incompletely characterized. The aim of this study was to characterize a H . pylori treatment resistant cohort compared to the cohorts of newly diagnosed, earlier eradicated and non-infected. Material and methods Patients were selected from routine referrals to the Endoscopy units at three different Norwegian hospitals. In all four cohorts, gastric biopsies were scored according to the Sydney classification, and symptoms according to the Gastrointestinal Symptom Rating Scale score, including sub-scores for upper gastrointestinal symptoms and functional bowel symptoms. Patients in the H . pylori resistant group were treated with a triple therapy regimen that consisted of levofloxacin, amoxicillin and a proton pump inhibitor. Results We included 185 patients, 42 H . pylori treatment resistant, 50 newly diagnosed, 61 previously H . pylori eradicated and 32 never infected. The treatment-resistant cohort had higher scores for upper gastrointestinal symptoms and functional bowel symptoms compared to the other groups except for the group being never H . pylori infected. The H . pylori resistant patients had lower Sydney scores than patients with newly diagnosed H . pylori infection. The triple combination showed a high efficacy of 91% to eradicate H . pylori . Conclusions Patients with treatment-resistant H . pylori infection had more gastrointestinal symptoms, but a lower Sydney score than patients with newly diagnosed infection. A treatment regimen including levofloxacin showed a high efficacy in eradicating H . pylori in patients that previously had failed eradication treatment.