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Smoking directly reduces the effectiveness of H. pylori eradication therapy, representing a critical barrier to treatment success in patients.
Helicobacter pylori (H. pylori) remains highly prevalent in Brazil, increasing the risk of gastritis, peptic ulcers, and gastric cancer. Although standard 14-day triple therapy with omeprazole, amoxicillin, and clarithromycin is recommended for all diagnosed patients, lifestyle factors such as smoking may influence treatment success. Researchers aimed to identify clinical and demographic factors associated with H. pylori eradication failure among 97 treatment-naive patients at a Brazilian university hospital.
In this retrospective observational study, volunteers (mean age of 55±14 years, 69.1% female) received empirical 14-day PPI-clarithromycin triple therapy (omeprazole 20 mg BID, amoxicillin 1 g BID, clarithromycin 500 mg BID). Elimination success was assessed using the 13C-urea breath test. The authors analyzed clinical and demographic variables, including age, sex, obesity, diabetes, psychiatric disorders, irritable bowel syndrome, fibromyalgia, smoking, cirrhosis, and alcoholism for associations with treatment failure.
Multiple regression analysis identified independent predictors of eradication failure. The 14-day antimicrobial regimen achieved a 90.7% eradication rate, demonstrating strong overall effectiveness. Smoking was identified as the sole factor substantially associated with H. pylori eradication failure (P=0.0068). Other clinical and demographic variables did not portray a substantial impact on outcomes.
The study confirmed that smoking was a distinct risk factor for H. pylori elimination failure. These findings emphasized the importance of incorporating lifestyle interventions, particularly smoking cessation, into treatment strategies to improve eradication rates and diminish persistent infection risks in high-prevalence populations.
Arquivos de gastroenterologia
SMOKING IMPACTS HELICOBACTER PYLORI ERADICATION: RESULTS FROM A BRAZILIAN UNIVERSITY HOSPITAL
Amanda Avesani Cavotto Furlan Relva da Fonte et al.
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