Evaluation of Amoxicillin-Clavulanic Acid Bismuth Combination for Helicobacter Pylori Eradication

Background and study aim: The prevalence of Helicobacter pylori (H. pylori) infection in Egypt is considered high, and its treatment is challenging due to high levels of antibiotic resistance. This study aimed to evaluate the effectiveness of a combination of amoxicillin-clavulanic acid with bismuth for H. pylori eradication.Patients and Methods: Three hundred patients with proven H. pylori Ag-positive in stool test were included. Patients who had previously received anti-H. pylori eradication therapy, and those with hypersensitivity to amoxicillin-clavulanic acid or bismuth were excluded from the study. All patients were treated with a combination of Amoxicillin 875 mg-Clavulanic acid 125 mg and Bismuth sub-citrate twice daily for 10 days. A test for H. pylori eradication using a fecal antigen test was performed 4 weeks after the end of treatment.Results: The main complaints observed in included patients were epigastric pain (38.3%), heartburn (33%), bloating (13.3%), loss of appetite (9.7%), nausea (6.7%), weight loss (2.3%), and abdominal pain (2.3%). There is no statistically significant association between H. pylori eradication and age, sex, comorbidities, smoking, or other presenting symptoms. The eradication rate of H. pylori 4 weeks after the end of treatment was 92.3%.Conclusion: H. pylori is prevalent, and its management with a combination of amoxicillin-clavulanic acid with bismuth is recommended.