Analysis Of The Risk Factors Of Bismuth Quadruple Therapy Failure For Helicobacter Pylori Eradication

BackgroundHelicobacter pylori(H.pylori)is closely related to many other diseases.Eradicating H.pylori can prevent the occurrence of these diseases.Eradication therapy for H.pylori can be divided into empirical therapy based on resistance rate and personal medication history and individualized therapy based on antimicrobial susceptibility test.Due to substandard treatment of the eradication therapy of H.pylori,the antibiotic resistance rate of H.pylori has been rising,which resulted in lower eradication rate.Under the background of high antibiotic resistance rate,Clarithromycin triple therapy is hard to achieve a satisfactory eradication rate.Bismuth quadruple therapy has been considered as the first line treatment for eradication of H.pylori.The reasons for eradication failure are many and varied.This study aimed to explore the risk factors associated with the failure of eradication therapy.MethodsIn this study,745 patients with H.pylori infection from the department of gastroenterology,Qilu hospital of Shandong university from December 2016 to December 2019 were enrolled in this study.According to the results of 13C-urea breath test 4-6 weeks after treatment,the patients were divided into the success group and the failure group.Independent risk factors associated with treatment failure were identified by multivariate logistic regression analysis.Factors including age,gender,height,weight,basic diseases,family history of gastric cancer,compliance,smoking and drinking,adverse reactions during eradication,previous eradication therapy and times of failure were collected.Pearson χ2 test were used for categorical data,t test for measurement data,and unconditional logistic regression analysis was used for multivariate analysis.ResultsA total of 745 subjects were included in the study,including 641 patients in the success group and 104 patients in the failure group.The H.pylori eradication rate were 86%.Univariate analysis showed that there were statistical differences in BMI,diabetes,family member infection,history of H.pylori eradication failure and patient compliance between the success group and the failure group.Multivariate analysis showed that poor compliance(OR:631,CI 2.256-17.656,p<0.001),history of H.pylori eradication failure(OR:1.765,CI 1.079-2.885,p=0.024),and diabetes(OR:2.372,CI 1.012-5.560,p=0.047)were independent risk factors for eradication failure.ConclusionPoor compliance,diabetes and history of history of H.pylori eradication failure were independent risk factors for the eradication failure of bismuth quadruple therapy.