Factors Affect the Eradication Rate of by Modified Quadruple Therapy: A Prospective Cohort Study.

Objective: This study aimed to investigate related factors affecting the eradication rate of (Hp) by modified quadruple therapy.

Methods: Between September 2020 and March 2021, 341 patients who were diagnosed with Hp infection and whose infections were confirmed by gastroscopy, a histological examination, and a C13-UBT without culturing and antimicrobial susceptibility studies received a two-week anti-Hp treatment, a modified quadruple therapy, in our department. The result of C13-UBT was rechecked 4 weeks after the drug withdrawal, and the patients were divided into two groups-a success group and a failure group-according to the final breath result. The general clinical information and related laboratory indexes of each patient were collected, and the factors affecting the eradication rate were analyzed.

Results: The total clinical eradication rate was 80.06% (273/341), and the failure rate was 19.94% (68/341), correspondingly. Univariate analysis identified statistically significant differences between the two groups in serum 25-hydroxyvitamin D levels, presence of oral diseases, positive cytotoxin-associated gene A (CagA), and medical compliance ( < 0.05). Meanwhile, the use of a proton pump inhibitor (PPIs) and antibiotics was statistically different ( < 0.05). Logistic regression analysis revealed that vitamin D level (<20 ng/mL) [OR = 98.56, 95% CI (29.01-334.83), < 0.001] and medical compliance [OR = 148.18, 95% CI (37.64-583.33), < 0.001] were independent effecting factors for eradication rate.

Conclusion: Serum 25-hydroxyvitamin D level lower than 20 ng/mL may affect the success of eradication of Hp and is an independent risk factor for eradication failure.