Pre-treatment urea breath test results predict the efficacy ofHelicobacter pylorieradication therapy in patients with active duodenal ulcers

AIM: To evaluate the association of pre-treatment (13)C-urea breath test (UBT) results with H pylori density and efficacy of eradication therapy in patients with active duodenal ulcers. METHODS: One hundred and seventeen consecutive outpatients with active duodenal ulcer and H pylori infection were recruited. H pylori density was histologically graded according to the Sydney system. Each patient received lansoprazole (30 mg b.i.d.), clarithromycin (500 mg b.i.d.) and amoxicillin (1 g b.i.d.) for 1 week. According to pre-treatment UBT values, patients were allocated into low (<16 per thousand), intermediate (16-35 per thousand), and high (>35 per thousand) UBT groups. RESULTS: A significant correlation was found between pre-treatment UBT results and H pylori density (P<0.001). H pylori eradication rates were 94.9%, 94.4% and 81.6% in the low, intermediate and high UBT groups, respectively (per protocol analysis, P=0.11). When patients were assigned into two groups (UBT results < or =35 per thousand and >35 per thousand), the eradication rates were 94.7% and 81.6%, respectively (P=0.04). CONCLUSION: The intragastric bacterial load of H pylori can be evaluated by UBT, and high pre-treatment UBT results can predict an adverse outcome of eradication therapy.