Clinical Characterization Ofhelicobacter Pyloriinfected Patients 15 Years After Unsuccessful Eradication

Background and aims Patients that have failed therapy forHelicobacter pylori(H.pylori) infection are incompletely characterized. The aim of this study was to characterize aH.pyloritreatment 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 theH.pyloriresistant group were treated with a triple therapy regimen that consisted of levofloxacin, amoxicillin and a proton pump inhibitor. Results We included 185 patients, 42H.pyloritreatment resistant, 50 newly diagnosed, 61 previouslyH.pylorieradicated 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 neverH.pyloriinfected. TheH.pyloriresistant patients had lower Sydney scores than patients with newly diagnosedH.pyloriinfection. The triple combination showed a high efficacy of 91% to eradicateH.pylori. Conclusions Patients with treatment-resistantH.pyloriinfection 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 eradicatingH.pyloriin patients that previously had failed eradication treatment.