Triple-drug combination therapy versus six-month proton pump inhibitor monotherapy in non-Helicobacter pylori Helicobacter eradication: a clinical study.

Abstract Background Reports on eradication of non- Helicobacter pylori Helicobacter (NHPH) gastritis in Japanese patients are rare. We investigated effectiveness of the standard triple-drug combination therapy for Helicobacter pylori eradication and of proton pump inhibitor (PPI) monotherapy in eradication of non- Helicobacter pylori Helicobacter . Methods Subjects were the patients who were diagnosed as NHPH-infected gastritis at Kenwakai Hospital between November 2010 and September 2021, whose NHPH species were identified by polymerase chain reaction (PCR) analysis of urease genes in endoscopically-biopsied samples, and who consented to eradication therapy of NHPH with either the triple-drug combination therapy for one week or PPI monotherapy for six months. Six months after the completion of the first-round eradication, its result was determined with esophagogastroduodenoscopy, microscopic examination, and urease gene analysis. In cases in which the first-round eradication therapy was unsuccessful, the second-round eradication with the other therapy than the first-round was suggested to the patient. Results PCR analysis detected NHPH in 38 patients: 36 as Helicobacter suis and two as Helicobacter heilmannii / Helicobacter ailurogastricus . Fourteen Helicobacter suis -infected and one Helicobacter heilmannii / Helicobacter ailurogastricus -infected patients requested eradication therapy. In the first-round eradication, the triple-drug combination therapy succeeded in four of five patients, while PPI monotherapy succeeded in five of 10 patients. Three of five patients who had been unsuccessful with the latter therapy requested the triple-drug combination therapy as the second-round eradication and all three were successful. In total, the triple-drug combination therapy succeeded in seven out of eight (87.5%) attempted cases, while PPI monotherapy in five out of 10 (50%) attempted cases. Conclusions Triple-drug combination therapy was also effective in NHPH eradication. PPI monotherapy for six months also appeared to be a promising option for eradicating NHPH. The effectiveness of the latter therapy may be attributed to NHPH’s preference for over-acidic environments and PPI’s antacid effects. Study registration: This study was approved by the Research Ethics Committee of Kenwakai Hospital (No. 2017024).