Published online Dec 16, 2024. doi: 10.12998/wjcc.v12.i35.6859
Revised: September 19, 2024
Accepted: October 9, 2024
Published online: December 16, 2024
Processing time: 158 Days and 16.8 Hours
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 treat
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.