[Evolution of the response to the first-line therapy for Helicobacter pylori infection in Uruguay]

The eradication rate of the Helicobacter pylori (H pylori) infection using standard triple therapy has dropped globally in recent years, primarily due to the occurrence of antibiotic resistance.

Several therapy regimens were assessed in 823 patients treated the first time for H pylori infection in Uruguay, during the 1997 to 2011 period, divided into five-year groups. All patients underwent 13C isotope-urea breath testing, between the 8th and 24th weeks after therapy. The standard triple plan (amoxicillin, clarithromycin and proton pump inhibitors) was the most commonly used (86.8%).

The overall eradication rate was 66.6% (548 patients). With the standard triple plan, the reported eradication rates were 75% for the first 5-year term and 70.1% for the second 5-year term. The difference between these two periods was not statistically significant (P = 0.201). However, in the last term the eradication rate further declined to 62.4%, with a statistically significant difference (P = 0.014). No significant correlations were found between the response to therapy in this population and either the use of alcohol and/or yerba mate or the smoking habits.

In Uruguay, the eradication rate of H pylori infection has dropped in the last five years and is below the internationally accepted levels. This feature demands searching for more effective alternative therapies, adapting the management to the national reality based on local antibiotic resistance patterns and drug availability.