Clarithromycin resistance, but not CYP2C-19 polymorphism, has a major impact on treatment success in 7-day treatment regimen for cure of H-pylori infection - A multiple logistic regression analysis

Mutations in the gene encoding the CYP2C-19 enzyme for PPI metabolism have been shown to enhance the chance for a cure in a H. pylori-positive patient s using a two-week dual-therapy regimen involving omeprazole and amoxicilli n. However, the impact of CYP2C-19 genetic polymorphism on eradication rate s of a one-week triple-therapy regimen has not been examined. In this cohor t study, 156 H. pylori-positive peptic ulcer or NUD patients who presented to our university hospital were recruited. They were treated by one-week om eprazole-amoxicillin-clarithromycin therapy. Host and bacterial predictive factors including H. pylori susceptibility and CYP2C-19 genotyping, as well as cure rate for H. pylori infection, were studied. Cure rate was 85.9% (9 5% CI: 79-91%) on an intent to treat (ITT) basis. By multiple logistic regr ession analysis, only clarithromycin resistance had a significant impact on treatment success (odds ratio 28.7: 95% CI: 6-172). CYP2C-19 genetic polym orphism was not associated with a significant change in cure rate. These ob servations indicate only clarithromycin susceptibility, not CYP2C-19 polymo rphism; has a major impact on the treatment success when using a seven-day OAC H. pylori treatment regimen.