Palmirotta R, Cafiero C, Colella M. Role of high-dose amoxicillin dual therapy for Helicobacter pylori eradication in an Irish cohort: A prospective study. World J Clin Cases 2024; 12(35): 6859-6863 [DOI: 10.12998/wjcc.v12.i35.6859]
Corresponding Author of This Article
Raffaele Palmirotta, MD, PhD, Associate Professor, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, P.zza G. Cesare, 11, Bari 70124, Italy. raffaelepalmirotta@gmail.com
Research Domain of This Article
Microbiology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Raffaele Palmirotta, Marica Colella, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Bari 70124, Italy
Concetta Cafiero, Area of Molecular Pathology, Anatomic Pathology Unit, Fabrizio Spaziani Hospital, Frosinone 03100, Italy
Author contributions: Palmirotta R, Cafiero C and Colella M contributed to this paper; Palmirotta R designed the overall concept and outline of the manuscript; Palmirotta R and Colella M contributed to the discussion and design of the manuscript; Palmirotta R, Colella M and Cafiero C contributed to the writing, editing the manuscript, and review of the literature; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raffaele Palmirotta, MD, PhD, Associate Professor, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, P.zza G. Cesare, 11, Bari 70124, Italy. raffaelepalmirotta@gmail.com
Received: May 18, 2024 Revised: September 19, 2024 Accepted: October 9, 2024 Published online: December 16, 2024 Processing time: 158 Days and 16.8 Hours
Abstract
Helicobacter pylori (H. pylori) infections may cause chronic gastritis, peptic ulcer disease, gastric cancers, and other conditions outside of the gastrointestinal tract. Hence, it is important to diagnose and treat it early. H. pylori is resistant to certain drugs in traditional eradication therapy, so alternative therapy protocols are needed, such as high-dose amoxicillin dual therapy (HDADT). This article aims to comment on a recent paper by Costigan et al in the World Journal of Clinical Cases. In this study, the authors recruited 139 patients diagnosed with H. pylori, all treated with HDADT. Of these, 93 were treatment-naïve and 46 had received at least one alternative treatment in the past. Four weeks after the end of the treatment, the urea breath test was administered to estimate the eradication rate. The total eradication rate was 56% (78/139), 62% for the treatment-naïve arm and 43% for the previous treatment arm, thus indicating a lower success rate for the arm that had previously received a different treatment regimen. In conclusion, a therapeutic approach with first-line HDADT may potentially be a better treatment, but the results are not sufficient to recommend the use of this regimen in a country with high levels of dual resistance.
Core Tip: Costigan et al conducted a prospective study to test high-dose amoxicillin dual therapy (HDADT) for Helicobacter pylori infections in an Irish cohort. Ireland is a high dual-resistance country for clarithromycin and metronidazole, so the traditional treatment does not work well. In addition, bismuth is not available in Ireland; therefore, the only recommended treatment is HDADT. The study considered in this editorial is the first to be conducted in Ireland, and it shows that HDADT does not always guarantee bacterial eradication.
