Related Experiment Video
Updated: Mar 13, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Safety and Efficacy of Esomeprazole-Containing Regimens for Helicobacter pylori Eradication: A Multicenter
Mohamed Alboraie1, Hatem Elalfy2, Mohamed M Mabrouk3
1Department of Internal Medicine, Al-Azhar University, Cairo, Egypt, alboraie@azhar.edu.eg.
Introduction:
Helicobacter pylori is a major global health challenge, causing significant gastrointestinal diseases and contributing to gastric cancer risk. This study evaluated the safety and efficacy of esomeprazole-containing regimens for H. pylori eradication in treatment-naïve and previously treated patients.
Methods:
This retrospective multicenter cohort study included 2,530 patients diagnosed with H. pylori infection. Patients received one of five esomeprazole-containing regimens for 14 days. Eradication was assessed 4-6 weeks post-treatment using stool antigen tests, urea breath tests, or histopathology. Analyses included intention to treat (ITT) and per protocol (PP). Demographics, socioeconomic status, prior treatment history, adverse events, and eradication rates were analyzed.
Results:
Of 2,530 enrolled, 2,489 were analyzed per protocol. The overall eradication rate was 87.3% (ITT) and 88.7% (PP). Treatment-naïve patients achieved higher eradication rates (89.7%) compared with previously treated patients (85.2%, p = 0.003). Bismuth subcitrate-based (96.5% PP in naïve; 86.7% in experienced) and doxycycline-based regimens (92.3% PP in naïve; 84.3% in experienced) demonstrated the highest efficacy. Adverse events occurred in 34.9% of patients, with no severe events. Socioeconomic status influenced outcomes, with eradication rates of 90.8% in high, 89.4% in middle, and 80.0% in low SES groups (p = 0.0001).
Conclusions:
Esomeprazole-containing regimens are effective and well tolerated for H. pylori eradication. Bismuth- and doxycycline-based quadruple therapies achieved the highest eradication rates, particularly in treatment-naïve patients. Tailored strategies incorporating bismuth or quadruple therapy may benefit patients with prior treatment failures or from lower socioeconomic backgrounds. Further research should consider regional resistance patterns and prospective designs.
More Related Videos
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
01:28Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:24Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...