Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection.

Abstract

BACKGROUND AND STUDY AIMS\nThe successful eradication rates with standard clarithromycin-based triple therapy are declining concerning the high antibiotic resistance rate and adverse drug reactions. This study aims to evaluate the effect of adding 1,25-hydroxyvitamin D3 on the eradication rates of the standard clarithromycin-based triple therapy for Helicobacter pylori infection.\n\n\nPATIENTS AND METHODS\nThis is a randomized prospective comparative study of 150 patients diagnosed with H. pylori gastritis using magnifying narrow-band imaging endoscopy and supported by a stool antigen test. Patients were divided into two groups: group A (n\xa0=\xa075) treated with amoxicillin, clarithromycin, and esomeprazole for 2\xa0weeks; group B (n\xa0=\xa075) treated with 1,25-hydroxyvitamin D3 for 1\xa0month plus amoxicillin, clarithromycin, and esomeprazole for 2\xa0weeks. The H. pylori eradication rates were assessed using stool antigen test conducted 4\xa0weeks after the end of therapy. Furthermore, the H. pylori eradication rates were assessed with per-protocol (PP) and intention-to-treat (ITT) analyses.\n\n\nRESULTS\nThe current results showed that H. pylori eradication was achieved in 46 of 62 (74.19%) and 46 of 75 (61.33%) patients via PP and ITT analyses, respectively, in group A. However, eradication was achieved in 60 of 68 (88.23%) and 60 of 75 (80%) patients via PP and ITT analyses, respectively, in group B. Therefore, the H. pylori eradication rates in the group where vitamin D3 was added to the clarithromycin-based triple therapy were significantly higher than in the other groups (p\xa0=\xa00.012 and p\xa0=\xa00.029 in ITT and PP analyses, respectively).\n\n\nCONCLUSIONS\nAdding vitamin D3 to the standard clarithromycin-based triple therapy could provide an additional advantage to achieve significantly higher eradication rates for H. pylori infection.