Time of Helicobacter pylori eradication assessment following treatment

The most appropriate time to assess accurately Helicobacter pylori eradication following treatment has been debated, with recommendations ranging from 1 to 3 months. The purpose of this study was to validate the assessment of H. pylori eradication 1 month following treatment.

Three randomized, double-blind, active-controlled clinical trials were conducted in patients with endoscopically verified, active duodenal ulcers and H. pylori infection. Patients were treated with various treatment regimens of omeprazole plus amoxicillin. Ulcer healing, H. pylori eradication, and ulcer relapse were examined. Patients underwent repeat endoscopy and biopsy at 1 and 6 months following treatment (or sooner if symptoms returned) to determine the recurrence of ulcers and H. pylori status. To determine the accuracy of measuring H. pylori eradication at 1 month posttreatment, we compared the H. pylori status at 1 month and 6 months following treatment.

In a combination of treatment groups and studies, a total of 384 evaluable patients represented data at both time points and were included in the analysis. Of those eradicated at 1 month posttreatment, 94% (141 of 150) remained eradicated at 6 months posttreatment. The proportion of patients with H. pylori eradicated at 1 month posttreatment did not differ significantly from that at 6 months posttreatment for each study. The overall efficiency of the two tests (agreement between tests) was 93% (359 of 384). Agreement between the 1-month and 6-month posttreatment H. pylori assessment was apparent, regardless of the treatment used.

H. pylori eradication measured 1 month following cessation of treatment accurately reflects successful treatment of the infection.