P3338 - Factors Associated With Therapeutic Failure in the Eradication of Helicobacter pylori in a Population in Northeast Colombia

Diana Carolina Ospina Galeano, ¹, German Manuel Tovar Fierro, ², Edgar Alberto Galvis Lozano, ³, Gabriel Ordoñez Parra, ³, Maria L. Luna-Gonzalez, ⁴, Miguel Enrique. Ochoa Vera, ⁴, Juan Martin Betancur Calderón, ⁵, Johan Ricardo González Rodríguez, ⁵, Andrea Juliana Gutiérrez Ortiz, ⁶, Fredy Humberto Suárez Vega, ⁷, Ana María Ospina Galeano, ^8
1Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia; ²Fundacion Oftalmologica de Santander FOSCAL, Bucaramanga, Santander, Colombia; ³Gastrocal, Floridablanca, Santander, Colombia; ⁴Universidad Autonoma de Bucaramanga, Bucaramanga, Santander, Colombia; ⁵Universidad Autónoma de Bucaramanga, Floridablanca, Santander, Colombia; ⁶Hospital Internacional de Colombia, Piedecuesta, Santander, Colombia; ⁷Clínica Bucaramanga, Giron, Santander, Colombia; ⁸Fundación para la Excelencia de la Medicina Clínica en Colombia, Bucaramanga, Santander, Colombia

Introduction: Globally, gastric cancer ranked sixth in incidence and seventh in mortality in 2022 (GLOBOCAN). In Colombia's northeastern region, it held the third highest incidence in 2022. Helicobacter pylori (H. pylori) infection is the primary risk factor for gastric cancer development. Understanding factors influencing treatment failure of H. pylori eradication is crucial. This study aimed to evaluate factors associated with therapy failure in a northeastern Colombian population.

Methods: This retrospective cohort study utilized anonymized secondary data from a quality control database for Gastrocal endoscopic procedures performed between January and June 2023. Pharmacological adherence (PA) to the H. pylori eradication regimen was assessed using the Morisky-Green Scale. Treatment failure was defined as a positive carbon-14 urea breath test result at six weeks post-antibiotic therapy completion. Relative risk (RR) with 95% confidence intervals (CI) and p-values were employed as effect measures. Statistical analysis was performed using STATA/SE v 14.0.

Results: A total of 87 patients were analyzed, with a mean age of 51 ± 14 years. The majority (62.07%) were women, and chronic superficial antral gastritis (73.56%) was the most frequent endoscopic finding. Eradication failure was observed in 16.1% of patients. Among those failing therapy, 40% had received one prior eradication regimen, and 70% had received two or more. Significantly lower eradication success rates were associated with amoxicillin (p=0.05), doxycycline (p=0.001), and metronidazole (p=0.01) use, as well as low PA (p=0.03). While esomeprazole use (RR=0.39, p=0.19) and age ≥ 40 years (RR=0.41, p=0.025) indicated a protective association, only prior eradication treatment (RR=3.59, p< 0.001) and low PA (RR=5.95, p=0.03) were statistically significant risk factors for treatment failure.

Discussion: This study in a northeastern Colombian population identified two key risk factors for H. pylori eradication therapy failure: prior eradication treatment and low pharmacological adherence. Conversely, age ≥ 40 years and esomeprazole use appeared to be protective factors. These findings highlight the importance of optimizing treatment regimens and promoting adherence to improve eradication succes.


Disclosures:


Diana Carolina Ospina Galeano, ¹, German Manuel Tovar Fierro, ², Edgar Alberto Galvis Lozano, ³, Gabriel Ordoñez Parra, ³, Maria L. Luna-Gonzalez, ⁴, Miguel Enrique. Ochoa Vera, ⁴, Juan Martin Betancur Calderón, ⁵, Johan Ricardo González Rodríguez, ⁵, Andrea Juliana Gutiérrez Ortiz, ⁶, Fredy Humberto Suárez Vega, ⁷, Ana María Ospina Galeano, ⁸. P3338 - Factors Associated With Therapeutic Failure in the Eradication of <i>Helicobacter pylori</i> in a Population in Northeast Colombia, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.