Factors modulating the outcome of treatment for the eradication of Helicobacter pylori infection.

A group of 180 H. pylori culture positive dyspeptic patients (64 patients with peptic ulcer, PU) completed a 2-week treatment with omeprazole, amoxicillin and metronidazole and underwent endoscopy again 6-8 weeks after the end of therapy. One hundred and twenty-four patients (68.8%) were successfully treated. Factors increasing the rates of eradication were the presence of PU (p=0.007) and anti-CagA serum antibodies (p=0.003). Factors negatively modulating eradication were the presence of coccoid forms (p=0.0008) and metronidazole-resistant strains (p=0.001); degrees of histological gastritis had no significant effect on eradication rates. Microscopic examination of smeared biopsies for the detection of the coccoid morphoytpe of H. pylori may help avoiding therapeutic failures.