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Does Long-Term Aspirin Use Have Any Effect On Helicobacter pylori Eradication?

Introduction:Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection, and recent reports from different countries report eradication rates lower than 80% with triple therapy. The aim of this pilot study was to investigate the efficacy of standard triple eradication regimen in long-term aspirin users. Method:The study population consisted of 77 aspirin using patients with dyspeptic symptoms and 79 age- and sex-matched dyspeptic patients without aspirin use as a control group. Both the study group and control patients were given lansoprazole (30 mg twice a day), clarithromycin (500 mg twice a day) and amoxicillin (1 g twice a day) (LCA) for 14 days as the eradication regimen. Patients on the study group were allowed to take aspirin during the eradication regimen (LCAAsp). Eradication was defined as the absence of H pylori as assessed with the 13C-urea breath test and H pylori stool antigen test 8 weeks after the end of the antimicrobial therapy. Results:The H pylori eradication rate in the LCAAsp group was 64/77 [83%, 95% confidence interval (CI): 79%–94%] with intention-to-treat (ITT) analysis and 64/75 (85%, 95% CI: 82%–96%) with per protocol (PP) analysis, and the H pylori eradication rate in the LCA group was 42/79 (53%, 95% CI: 43%–65%) with ITT analysis and 42/75 (56%, 95% CI: 46%–68%) with PP analysis. The difference between the groups both with ITT analysis and with PP analysis was statistically significant (P < 0.05). Conclusion:These data suggest that H pylori eradication rate with standard triple eradication regimen is significantly higher among long-term aspirin users than in controls.