How Effective Is the Quadruple Concomitant Helicobacter Pylori Eradication Therapy for Obese Patients Undergoing Gastric Bypass Surgery?

Aims and Methods Our aim was to assess, in obese patients undergoing Roux-en Y gastric bypass surgery, the quadruple concomitant HP eradication rates at first line treatment as proposed by the Maastricht IV consensus in areas of high clarithromycin resistance rates-proton pump inhibitor bid, clarithromycin 500 mg bid, amoxicillin 1000 mg bid, and metronidazole 500 mg bid. This is a single center prospective study over a 3-year period. Endoscopy and HP assessment (by histology or C13 urea breath) were performed at baseline, and post treatment HP status was assessed by C13 urea breath test 4-6 weeks after the end of therapy. Results The study cohort consisted of 600 adult obese HP positive patients [19 % male/81 % female, age 40.7 (+/- 10.4) years] consecutively scheduled for HP concomitant therapy. HP was eradicated in 416 patients [69.3 % (95% CI 65.5-72.9 %)] and the eradication was independent of gender, age, endoscopic diagnosis, and smoking status (p > 0.05). Conclusions Two weeks quadruple concomitant therapy did not achieve Maastricht recommended first line acceptable HP eradication rates (at least 80 %) in obese Portuguese patients undergoing GB.