13C-Urea Breath Test Values and Helicobacter pylori Eradication

Abstract

Delta over baseline (DOB) values of 13C-urea breath test (UBT) have been shown to be predictive of H. pylori eradication following therapy. This was a post hoc analysis of a large, double-blind, randomized trial. Consecutive patients with a positive UBT underwent upper endoscopy. H. pylori strains were tested for clarithromycin resistance. All patients received an eradication therapy with either a standard 10-day triple therapy or a 10-day sequential regimen. The infection was considered cured when two consecutive UBTs were negative. Basal DOB values were categorized as low (<16), intermediate (16-35), or high (>35). A total of 282 patients were selected. Eradication rates did not differ between patients with high and low DOB values. No significant difference in DOB values emerged between patients infected with clarithromycin-susceptible and clarithromycin-resistant strains. Under multivariate analysis, DOB values did not influence the bacterial eradication, which was significantly affected only by the presence of clarithromycin resistance. This large analysis failed to demonstrate a role for DOB value in H. pylori eradication with either a 10-day triple or sequential therapy.

Helicobacter pylori treatment in the era of increasing antibiotic resistance

“…Concomitant treatment consistently achieves grade A or B levels of effectiveness and has been evaluated in a variety of populations including Japan, Taiwan, Colombia and several countries throughout Europe (figure 4). 9 73–76 128–132 Likewise, the recommended sequential treatment provides a high level of effectiveness in Italy, Korea, Taiwan and the USA14 42 44 52 63 65 70 132–138 (figure 5) (Ping-I Hsu, Kaohsiung Hp Treatment Group, unpublished data) and recently in Japan as a second-line treatment for those who had failed ‘legacy triple therapy’ 139. However, in Korea, sequential treatment achieved success of only 86% (95% CI 75% to 93%), which may have been related to higher rates of dual resistance locally 13.…”

“…Per-protocol (PP) treatment success and 95% CIs for sequential quadruple treatment.The data are shown left to right in order of the year of publication 14 42 44 52 63 65 70 132–138. Treatment success is also graded using the Report Card scoring system 91.…”

An Update on 13C-Breath Tests: The Transition to Acceptability into Clinical Practice

“…16 Infection by this bacterium could potentially result in various gastroduodenal diseases such as peptic ulcer, functional dyspepsia, MALT lymphoma, and [23][24][25] compare the accuracy of the UBT to several other invasive diagnostic tests such as gastric biopsies performed during endoscopy (rapid urease test, histology, culture) and a large number of papers [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] have focused on the efficacy of eradication therapy and the selection of alternate therapies. 16 Infection by this bacterium could potentially result in various gastroduodenal diseases such as peptic ulcer, functional dyspepsia, MALT lymphoma, and [23][24][25] compare the accuracy of the UBT to several other invasive diagnostic tests such as gastric biopsies performed during endoscopy (rapid urease test, histology, culture) and a large number of papers [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]…”

“…46 However, scintigraphy is not generally available at all major healthcare centers, and involves radiation exposure, precluding its use in pregnant patients and children. Researchers have now reduced the number of sample collections to just five time points (45,90,120,150, and 180 min) post ingestion of 13 C-substrate making the test more user friendly. 47 These substrates are rapidly absorbed in the proximal small intestine, metabolized in the liver with the generation of 13 CO 2 which is exhaled rapidly with low interindividual variability.…”

A Comparison of Five Different Treatment Regimens as the First‐Line Treatment of Helicobacter pylori in Turkey

“…Due to increasing antibiotic resistance, triple therapyeradication success rates as high as 90% have been reduced down to as low as 50-60% some regions. In addition, variable results have been reported with respect to the role of sex, smoking status, bacterial density, and gastric pathology [12]. In addition, variable results have been reported with respect to the role of sex, smoking status, bacterial density, and gastric pathology [12].…”