Triple-drug combination therapy versus six-month proton pump inhibitor monotherapy in non-Helicobacter pylori Helicobacter eradication, and hyperacid environment preference of Helicobacter suis: a clinical study
- PMID: 38720287
- PMCID: PMC11080111
- DOI: 10.1186/s12876-024-03252-5
Triple-drug combination therapy versus six-month proton pump inhibitor monotherapy in non-Helicobacter pylori Helicobacter eradication, and hyperacid environment preference of Helicobacter suis: a clinical study
Abstract
Background: At present, eradication regimens for non-Helicobacter pylori Helicobacter (NHPH) have not been established yet. We investigated effectiveness of the standard triple-drug combination therapy for Helicobacter pylori eradication and of a proton pump inhibitor (PPI) monotherapy in eradication of NHPH.
Methods: Subjects were the patients who were diagnosed with NHPH-infected gastritis based on microscopic findings, helical-shaped organisms obviously larger than Helicobacter pylori, in the gastric mucosal specimens using Giemsa staining at Kenwakai Hospital between November 2010 and September 2021, whose NHPH species were identified by polymerase chain reaction (PCR) analysis of urease genes in endoscopically-biopsied samples, and who consented to NHPH eradication with either the triple-drug combination therapy for one week or a PPI monotherapy for six months. Six months after the completion of eradication, its result was determined with esophagogastroduodenoscopy, microscopic examination, and PCR analysis. In cases of unsuccessful eradication, a second eradication with the other therapy was suggested to the patient.
Results: PCR analysis detected NHPH in 38 patients: 36 as Helicobacter suis and two as Helicobacter heilmannii/Helicobacter ailurogastricus. Fourteen Helicobacter suis-infected and one Helicobacter heilmannii/Helicobacter ailurogastricus-infected patients requested eradication therapy. The triple-drug combination therapy succeeded in four of five patients, while the PPI monotherapy succeeded in five of 10 patients. Three of five patients who had been unsuccessful with the latter therapy requested the triple-drug combination therapy as the second eradication and all three were successful. In total, the triple-drug combination therapy succeeded in seven out of eight (87.5%) attempted cases, while the PPI monotherapy in five out of 10 (50%) attempted cases.
Conclusions: In NHPH eradication, the triple-drug combination therapy was considered to be effective to some extent and to become the first-line therapy. While, although less successful, PPI monotherapy appeared to be a potentially promising option particularly for patients with allergy or resistance to antibiotics. Effectiveness of PPI monotherapy may be attributed to hyperacid environment preference of Helicobacter suis and PPI's acid-suppressive effect. Additionally, male predominance in NHPH-infected gastritis patients may be explained by gender difference in gastric acid secretory capacity. However, further evidence needs to be accumulated.
Study registration: This study was approved by the Research Ethics Committee of Kenwakai Hospital (No. 2,017,024).
Keywords: Helicobacter suis; Eradication; Gender; Hyperacid environment.; Non-Helicobacter pylori Helicobacter; Proton pump inhibitor; Triple-drug combination therapy.
© 2024. The Author(s).
Conflict of interest statement
The authors declare no competing interests.
Figures
Similar articles
-
PCR analysis and specific immunohistochemistry revealing a high prevalence of non-Helicobacter pylori Helicobacters in Helicobacter pylori-negative gastric disease patients in Japan: High susceptibility to an Hp eradication regimen.Helicobacter. 2020 Oct;25(5):e12700. doi: 10.1111/hel.12700. Epub 2020 Aug 13. Helicobacter. 2020. PMID: 32790220
-
Helicobacter suis infection is associated with nodular gastritis-like appearance of gastric mucosa-associated lymphoid tissue lymphoma.Cancer Med. 2019 Aug;8(9):4370-4379. doi: 10.1002/cam4.2314. Epub 2019 Jun 18. Cancer Med. 2019. PMID: 31210418 Free PMC article.
-
Effect of the mucolytic erdosteine on the success rate of PPI-based first-line triple therapy for Helicobacter pylori eradication: a prospective, double-blind, randomized, placebo-controlled study.Scand J Gastroenterol. 2010 Jun;45(6):677-83. doi: 10.3109/00365521003702726. Scand J Gastroenterol. 2010. PMID: 20334478 Clinical Trial.
-
Standard triple therapy in Helicobacter pylori eradication in Turkey: Systematic evaluation and meta-analysis of 10-year studies.Turk J Gastroenterol. 2019 May;30(5):420-435. doi: 10.5152/tjg.2019.18693. Turk J Gastroenterol. 2019. PMID: 31060997 Free PMC article.
-
Efficacy of Vonoprazan for Helicobacter pylori Eradication.Intern Med. 2020 Jan 15;59(2):153-161. doi: 10.2169/internalmedicine.2521-18. Epub 2019 Jun 27. Intern Med. 2020. PMID: 31243237 Free PMC article. Review.
Cited by
-
Enlargement of Gastric Hyperplastic Polyps Arising from Helicobacter heilmannii sensu stricto-infected Mucosa after the Successful Eradication of Helicobacter pylori and the Long-Term Use of a Proton Pump Inhibitor.Intern Med. 2025 Jun 1;64(11):1677-1683. doi: 10.2169/internalmedicine.4230-24. Epub 2024 Nov 8. Intern Med. 2025. PMID: 39523000 Free PMC article.
References
-
- Heilmann KL, Nowottny U. Histological demonstration of Campylobacter-like organisms in stomach biopsy. Dtsch Med Wochenschr. 1987;112:861–2. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical