Is there any correlation between 13C-urea breath test values and response to first-line and rescue Helicobacter pylori eradication therapies?

Aim. To study if there is a correlation between C-13-urea breath test values prior to treatment and the response to first-line and rescue Helicobacter pylori eradication therapies. Methods. Six-hundred patients with peptic ulcer or functional dyspepsia infected by H. pylori were prospectively studied. Pre-treatment H. pylori infection was established by 13C-urea breath test. Three-hundred and twelve patients were treated with first-line eradication regimen, and 288 received a rescue regimen. H. pylori eradication was defined as a negative 13C-urea breath test, 8 weeks after completion of treatment. Results. H. pylori eradication was achieved in 444 patients. No statistically significant differences were demonstrated when mean delta(13)C-urea breath test values were compared between patients with eradication success and failure (49.4 +/- 33 versus 49.2 +/- 3 1). Differences in mean pre-treatment delta(13)CO(2) between patients with eradication success/failure were not demonstrated either when first-line or rescue regimens were prescribed. With the cut-off point of pre-treatment delta(13)CO(2), set at 35 units, sensitivity and specificity for the prediction of H. pylori eradication success was 43 and 60%. The area under the receiver operating characteristic curve evaluating all the cut-off points of the pre-treatment delta(13)CO(2) for the diagnosis of H. pylori eradication was 0.5. Finally, delta(13)CO(2) values did not influence the eradication in the logistic regression model. Conclusion. No correlation was observed between C-13-urea breath test values before treatment and the response to first-line and rescue H. pylori eradication therapies. Therefore, we conclude that the quantification of delta(13)CO(2) prior to treatment is not useful to predict the success or failure of eradicating therapy. (c) 2005 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.