Pre-treatment: urea breath test results predict the efficacy of Helicobacter pylori eradication therapy in patients with active duodenal ulcers

AIM:To evaluate the association of pre-treatment13C-ureabreath test (UBT) results with H pylori density and efficacyof eradication therapy in patients with active duodenalulcers.METHODS:One hundred and seventeen consecutiveoutpatients with active duodenal ulcer and H pylori infectionwere recruited.H pylori density was histologically gradedaccording to the Sydney system.Each patient receivedlansoprazole (30 mg b.i.d.),clarithromycin (500 mg b.i.d.)and amoxicillin (1 g b.i.d.) for 1 week.According to pre-treatmentUBT values,patients were allocated into low (<16‰),intermediate (16-35‰),and high (>35‰) UBT groups.RESULTS:A significant correlation was found betweenpre-treatment UBT results and H pylori density (P<0.001).H pylori eradication rates were 94.9%,94.4% and 81.6%in the low,intermediate and high UBT groups,respectively(per protocol analysis,P=0.11).When patients wereassigned into two groups (UBT results≤35‰ and >35‰),the eradication rates were 94.7% and 81.6%,respectively(P=0.04).CONCLUSION:The intraclastric bacterial load of H pylorican be evaluated by UBT,and high pre-treatment UBTresults can predict an adverse outcome of eradicationtherapy.