Does pretreatment with proton pump inhibitors influence the eradication rate of Helicobacter pylori?

Background/Aims: Pretreatment with a proton pump inhibitor (PPI) has been reported to decrease the efficacy of Helicobacter pylori (H. pylori) eradication. We compared the efficacy of an eradication regimen (lansoprazole/amoxicillin/clarithromycin) first or following pretreatment with a PPI. Methodology: In this retrospective study conducted at three centers, 353 patients infected with H. pylori were treated. The H. pylori status was determined using the rapid urease test, bacterial cultures, and the histological examination of endoscopic biopsy specimens. The patients were assigned to receive an eradication regimen first or following pretreatment with a PPI. Eradication was assessed using the C-13-urea breath test more than 4 weeks after the completion of therapy. Results: Overall, H. pylori was eradicated in 78.8% of the cases: 79.6% in the pretreatment group, and 77.6% in the eradication first group (p=0.6541 by chi square test). No significant difference in the eradication rates was observed between the two groups. Conclusions: This retrospective study indicated that pretreatment with a PPI does not significantly reduce the efficacy of eradication therapy in patients infected with H. pylori.