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. 2025 Aug 1;57(12):103344.
doi: 10.1016/j.aprim.2025.103344. Online ahead of print.

[Clinical and microbiological effectiveness of Helicobacter pylori eradication treatment with triple therapy]

[Article in Spanish]
Yasmin Ghandour Fawaz  1 , Nagore Rojo Ruiz  2 , Javier Díaz Núñez  2 , Alba Sariola Molins  2 , Saúl Barreales Soto  3 , Jordi Vilaseca Canals  2
Affiliations

[Clinical and microbiological effectiveness of Helicobacter pylori eradication treatment with triple therapy]

[Article in Spanish]
Yasmin Ghandour Fawaz et al. Aten Primaria. .

Abstract
in English, Spanish

Objective: To estimate the eradication rate of Helicobacter pylori (HP) with triple therapy (amoxicillin 1g/12h, clarithromycin 500mg/12h, and omeprazole 20mg/12h/for 14 days) and to evaluate its clinical effectiveness in improving symptoms associated with HP infection. This is an observational, prospective, exposed cohort study.

Desing: Prospective observational cohort study of exposed groups.

Setting: Urban health area with follow-up in primary care.

Participants: A total of 125 patients (68% women, 32% men) with untreated HP infection or who had not received eradication treatment in the last year were included, with a mean age of 52.2 years (SD ±17.5).

Interventions: Three visits were conducted. During visit 1, informed consent was obtained, the main and secondary symptoms were recorded, and treatment was prescribed. In visit 2, after completing the treatment, adverse effects, adherence (Morisky-Green test), and clinical evolution were recorded. In visit 3, the eradication test result was verified.

Main measurements: Demographic, symptomatology, eradication, adherence, and adverse effects variables were collected.

Results: The eradication rate was 92% (95% CI: 85.90-95.60%). Of these, 93.90% (95% CI: 88-97%) showed improvement or resolution of their symptoms. Therapeutic adherence was 80.80% (95% CI: 73.02-86.74%). Adverse effects appeared in 41.60% of patients, of which 35.20% were digestive-related.

Conclusions: The study supports triple therapy as a first-line option for HP infection in primary care in our setting. The majority of patients experienced a progressive improvement in their symptoms.

Objetivo: Estimar la proporción de erradicación del Helicobacter pylori (HP) con la terapia triple (amoxicilina 1 g/12 h, claritromicina 500 mg/12 h y omeprazol 20 mg/12 h/durante 14 días) y evaluar su efectividad clínica en la mejoría de síntomas asociados a la infección por HP.

Diseño: Observacional, prospectivo de cohortes expuestas.

Emplazamiento: Área de salud urbana con seguimiento en atención primaria.

Participantes: Se han incluido 125 pacientes (mujeres 68%, varones 32%) con infección por HP no tratada o que no han recibido tratamiento erradicador en el último año, con una edad media de 52,2 años (DE ± 17,5).

Intervenciones: Se han realizado 3 visitas, en la visita 1 se solicita el consentimiento informado, se registra síntoma principal y secundarios y se indica tratamiento. En la visita 2, tras finalizar el tratamiento, se registran efectos adversos del mismo, adherencia (test de Morisky-Green) y evolución clínica. En la visita 3 se comprueba el resultado del test de erradicación.

Mediciones principales: Se han recogido variables demográficas, de sintomatología, erradicación, adherencia, así como de efectos adversos.

Resultados: La proporción de erradicación ha sido del 92% (IC 95%: 85,90-95,60%). De ellos, el 93,90% (IC 95%: 88-97%) ha mejorado o resuelto su sintomatología. La adherencia terapéutica ha sido del 80,80% (IC 95%: 73,02-86,74%). Aparecieron efectos adversos en el 41,60%, de los cuales el 35,20% fueron de tipo digestivo.

Conclusiones: El estudio respalda la terapia triple como opción de primera línea para la infección por HP en la atención primaria de nuestro entorno. La mayoría de los pacientes experimentan una mejoría progresiva de sus síntomas.

Keywords: Atención primaria; Helicobacter pylori; Primary health care; Resultado del tratamiento; Treatment outcome.

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