Martin Cuesta Hernandez

Helicobacter Pylori (HP) infection in obese patients undergoing Roux-en-Y gastric bypass: efficacy of two different treatment regimens in HP eradication

INTRODUCTION the ultimate cause for the increased incidence of gastric ulcer following Roux-en-Y gastric bypass (RYGB) remains unclear. Treatment of HP infection is recommended before surgery in countries with high prevalence such as Spain in other to diminish the risk. However, the current regimens used might not be adequate in view of the high failure rate for HP eradication. METHODS we reviewed 243 patients retrospectively undergoing RYGB and found 111 patients (45%) with HP infection. Therefore, we compared the eradication rate between 2 different regimens. RESULTS 70 patients received OCA(Omeprazole:20 mg/12h, Clarithromycin 500 mg/12h and Amoxicillin 1 gram/12h for 10 days) while 41 patients received OLA (Omeprazole 20 mg/12 hours, Levofloxacin 500 mg/12hours and Amoxicillin 1 gram/12h for 10 days) for HP eradication. In 56/70 (80%) patients receiving OCA therapy HP was eradicated compared to 37/41 (91%) receiving OLA as first line therapy (p = 0.283). When used as second line therapy, in 13/14 (92%) patients receiving OLA HP was eradicated. CONCLUSION clarithromycin resistance remains a matter of concern in this population while OLA seems to be a good alternative therapy for HP eradication, especially when OCA regimen fails.