Impact of insufficient doses of medications on <i>Helicobacter pylori</i> eradication: a retrospective observational study
Creators: name: Shi, Xiaoye
name: Wang, Chunmei
name: Meng, Fanjun
name: Ma, Shaoze
name: Xu, Guangqin
name: Liu, Tingwei
name: Guo, Xiaozhong
name: Li, Hongyu
name: Qi, Xingshun
Publisher: name: Taylor & Francis
Year: 2022
Subjects: subject: Biochemistry
subject: Space Science
subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Cell Biology
subject: Pharmacology
subject: Immunology
subject: FOS: Clinical medicine
subject: Biological Sciences not elsewhere classified
subject: Mathematical Sciences not elsewhere classified
subject: Cancer
subject: Science Policy
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Virology
subject: Computational Biology

description: The doses of medications may influence the success of <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication. This real-world observational study aimed to explore the impact of insufficient doses of medications prescribed for the bismuth-containing quadruple therapy (BQT) regimen on successful <i>H. pylori</i> eradication. We retrospectively screened the patients who were diagnosed with <i>H. pylori</i> infection and received BQT regimens for <i>H. pylori</i> eradication at our department between January 2017 and July 2020. The rate of successful <i>H. pylori</i> eradication was compared according to the doses of medications prescribed. Standard doses were defined according to the clinical guidelines. Overall, 1054 patients were included. The rate of successful <i>H. pylori</i> eradication was 78.2% (824/1054). Among them, proton pump inhibitors (PPIs) and antibiotics were prescribed at insufficient doses in 37.0% (390/1054) and 6.7% (71/1054) of patients, respectively. Furthermore, pantoprazole (98.7% [385/390]) was the most common type of PPIs prescribed at insufficient doses, and nitroimidazoles (85.9% [61/71]) were the most common type of antibiotics prescribed at insufficient doses. Among the patients receiving colloidal bismuth pectin (CBP) (200 mg tid) and standard-dose antibiotics, the rate of successful <i>H. pylori</i> eradication was lower in insufficient-dose PPIs group than standard-dose PPIs group (78.1% [271/347] versus 82.6% [438/530], P = 0.095). Among the patients receiving CBP (200 mg tid) and standard-dose PPIs, the rate of successful <i>H. pylori</i> eradication was significantly lower in insufficient-dose antibiotics group than standard-dose antibiotics group (37.8% [14/37] versus 82.6% [438/530], P &lt; 0.0001). Among the patients receiving CBP 200 mg tid, the rate of successful <i>H. pylori</i> eradication was significantly lower in patients receiving both PPIs and antibiotics at insufficient doses than those at standard doses (46.4% [13/28] versus 82.6% [438/530], P &lt; 0.0001). Among the BQT regimens, PPIs and/or antibiotics, especially pantoprazole and metronidazole, are often prescribed at insufficient doses, compromising the success of <i>H. pylori</i> eradication. <i>H. pylori, Helicobacter pylori</i>; UBT, urea breath test; DPM, disintegrations per minute; BQT, bismuth-containing quadruple therapy; PPI, proton pump inhibitor; CBP, colloidal bismuth pectin; qd, once daily; bid, twice daily; tid, three times daily; qid, four times daily.