Rare incidence of interspousal transmission of Helicobacter pylori in asymptomatic individuals in Japan

PCR-restriction fragment length polymorphism electrophoretic patterns of amplified ureB and ureC of Helicobacter pylori were compared between spouses after digestion with restriction endonucleases. Twenty of 21 couples, both members of which were positive for H. pylori, showed ureB and ureC patterns that differed between spouses. We concluded that in Japan, interspousal transmission of H. pylori occurs rarely.

Relationship between the eradication of Helicobacter pylori and the healing pattern of peptic ulcer

We investigated the relationship between the eradication of Helicobacter pylori and the stage after the eradication of this bacterium. Eighty-six patients with H. pylori who had gastric ulcer (n=45) or duodenal ulcer (n=41) were enrolled in the study. As eradication therapy, patients received 1,500 mg amoxicillin, 400 mg clarithromycin, and 30 mg lansoprazole for 2 weeks, followed by 30 mg lansoprazole for 6 weeks in patients with gastric ulcer or for 4 weeks in those with duodenal ulcer. The ulcer stages were evaluated using the indigocarmine method at the third and sixth month after entry. The overall eradication rate of H. pylori was 85% in this study. In the gastric ulcer group, 62% of H. pylori-eradicated patients and 37.5% of H. pylori-uneradicated patients showed the S2 stage (white scar) at the sixth month. In the duodenal ulcer group, 61% of H. pylori-eradicated patients showed the S2 stage and none of the H. pylori-uneradicated patients showed the S2 stage (p < 0.05). We concluded that H. pylori eradication might promote not ulcer healing but maturity of the ulcer scar, especially in duodenal ulcer patients, and that this might also be related to the reduction of ulcer relapse.

Assessment of a new triple agent regimen for the eradication of Helicobacter pylori and the nature of H. pylori resistance to this therapy in Japan

BACKGROUND

Multiple regimens for the eradication of Helicobacter pylori have been tested, but the best therapy has not been determined yet. To determine the efficacy of a new triple agent regimen using a combination of lansoprazole, amoxicillin, and clarithromycin against Helicobacter pylori (H. pylori), and to examine H. pylori resistance to this therapy in ineffective cases.

METHODS

We studied a total of 71 patients infected with H. pylori who had gastric ulcer (n = 37) or duodenal ulcer (n = 34) as confirmed by endoscopy. Patients received 1500 mg amoxicillin, 400 mg clarithromycin and 30 mg lansoprazole for 2 weeks followed by 30 mg lansoprazole for 6 weeks in patients with gastric ulcer or for 4 weeks in those with duodenal ulcer. Endoscopic examination was performed before treatment and at 1 month, 2 months, and 5 months after initiating treatment to check the status of ulceration and H. pylori infection.

RESULTS

The eradication rate of H. pylori was 92% (CI, 83-100%) in the gastric ulcer group and 94% (CI, 86-100%) in the duodenal ulcer group at 5 months, as determined by per-protocol analysis. Resistance to clarithromycin was present in 1 of 71 (1%) patients before treatment and in 2 of 5 (40%) patients after treatment. No resistance to amoxicillin and lansoprazole was found in patients before or after treatment. The resistance to clarithromycin changed during the observation period.

CONCLUSIONS

The new triple agent regimen was effective against H. pylori. Resistance to clarithromycin may not be permanent and it might be one of the risk factors which affect the efficacy of a clarithromycin-based therapy.