Eradication rates of Helicobacter pylori regimens and predictors of treatment failure: A multicenter real-world study in Saudi Arabia
Rattachement africain : sa, Égypte, ae. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: The increasing prevalence of Helicobacter pylori resistance to clarithromycin and other antibiotics has led to a decline in eradication rates globally. Limited multicenter data from Saudi Arabia exist regarding the comparative effectiveness of various eradication regimens and predictors of treatment failure. This study aimed to evaluate eradication outcomes across different therapeutic lines and identify predictors of eradication failure in a real-world Saudi population. Methods: A retrospective multicenter cohort study was conducted across several tertiary hospitals in Saudi Arabia, from January 2020 to December 2024. Adult patients with confirmed H. pylori infection who received first-line or subsequent eradication therapy were included. Data were collected from electronic medical records, including demographic characteristics, comorbidities, diagnostic methods, treatment regimens, and therapy outcomes. Eradication success was confirmed by urea breath, stool antigen testing, or histopathology, at least four weeks post-therapy. Multivariate logistic regression was used to identify independent predictors of eradication failure. Results: A total of 690 patients were included (61.0% female; mean age 41 ± 13 years). Concomitant quadruple therapy was the most frequently prescribed regimen (49.0%), followed by standard triple therapy (25.9%). Eradication rates were significantly higher for concomitant (90.2%), levofloxacin-based regimens (87.8%) compared with standard triple therapy (73.7%; P < 0.001). There was no treatment failure among the 28 patients who received bismuth-based therapy, resulting in a 100% eradication rate. Univariate analysis suggested cardiovascular disease as a potential predictor of treatment failure (P = 0.03), but no independent predictors were identified after multivariate adjustment. No demographic or medication-related variables significantly influenced eradication outcomes. Conclusion: In this large, real-world Saudi cohort, concomitant and levofloxacin-based regimens achieved excellent H. pylori eradication rates, while bismuth-based therapy is effective; the reported eradication rate of 100% is most likely inflated, given the small number of patients who received this regimen. In contrast, standard triple therapy showed suboptimal efficacy, likely due to clarithromycin resistance. The findings support replacing triple therapy with quadruple bismuth-containing or non-bismuth-based therapies, or levofloxacin-containing regimens, as first-line therapy, and highlight the need for local antimicrobial resistance surveillance to guide treatment strategies.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Eradication rates of Helicobacter pylori regimens and predictors of treatment failure: A multicenter real-world study in Saudi Arabia
- Date Crossref
- 21/01/2026
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Umm al-Qura University pays non établi dans la noticeUniversité ou école supérieure
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King Fahd Hospital of the University pays non établi dans la noticeÉtablissement de santé
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King Saud bin Abdulaziz University for Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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King Abdullah International Medical Research Center pays non établi dans la noticeStructure de recherche
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National Guard Health Affairs Department of Medicine pays non établi dans la noticeÉtablissement de santé
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King Faisal Specialist Hospital & Research Centre pays non établi dans la noticeÉtablissement de santé
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Menoufia University Department of Hepatology and Gastroenterology Menoufia University, Égypte (code pays fourni par la source)Université ou école supérieure
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Imam Abdulrahman Bin Faisal University pays non établi dans la noticeUniversité ou école supérieure
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Qassim University pays non établi dans la noticeUniversité ou école supérieure
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Prince Sattam Bin Abdulaziz University pays non établi dans la noticeUniversité ou école supérieure
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King Fahad Specialist Hospital Department of Internal Medicine pays non établi dans la noticeÉtablissement de santé
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Al Noor Hospitals pays non établi dans la noticeÉtablissement de santé
Umm al-Qura University, King Fahd Hospital of the University et King Saud bin Abdulaziz University for Health Sciences, avec 9 autres affiliations. Pays d’affiliation : Égypte.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.