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Background <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication regimens may have different effects on the gut microbiota. Few studies have analyzed the safety of high-dose dual therapy (HDDT) from a micro-ecological perspective. This study aimed to compare the impact of <i>H. pylori</i> eradication with HDDT and bismuth quadruple therapy (BQT) on gut microbiota.</p> Patients and methods <p>H. Pylori-infected treatment-naive patients were recruited and screened from September 2023 to April 2024 and randomly assigned to the HDDT group (esomeprazole 20&#xa0;mg, amoxicillin 750&#xa0;mg, qid, 14 days) or BQT group (esomeprazole 20&#xa0;mg, amoxicillin 1000&#xa0;mg, clarithromycin 500&#xa0;mg, and bismuth potassium citrate 600&#xa0;mg, bid, 14 days). Fresh stool specimens were collected and stored before treatment and at week 2 and week 8 after treatment. The diversity and composition of the gut microbiota were compared and analyzed in both groups using 16&#xa0;S rRNA gene sequencing.</p> Results <p>Forty-nine <i>H. pylori</i> positive patients were enrolled and randomly assigned to either the HDDT (<i>n</i> = 24) or the BQT group (<i>n</i> = 25) group. Compared with baseline, alpha and beta diversities significantly changed at week 2 after receiving BQT and did not recover fully at week 8. However, in the HDDT group, the diversities at week 2 changed mildly without statistical significance, compared to baseline. Additionally, a greater number of species had alterations in their abundances in the BQT group compared to the HDDT group at week 2. However, the abundances of these species were restored to their previous levels at week 8 in both the HDDT and BQT groups.</p> Conclusions <p>Compared to BQT, HDDT exerted less impact on the diversity and composition of the gut microbiota.</p> Clinical trial registration <p>ChiCTR2100053268.</p>

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High-dose dual therapy for Helicobacter pylori eradication inducing less impact on the gut microbiota

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月30日

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  • Jia-Lun Guan,
  • Ting-Ting Xu,
  • Ya Lin,
  • Yan-Shuai Mo,
  • Bi-Yu He,
  • Ying-Ying Han,
  • Ji-Yan Li,
  • Su-Hong Xia,
  • Ya-Ni Zhou,
  • Jia-Zhi Liao,
  • Pei-Yuan Li

摘要

Background

Helicobacter pylori (H. pylori) eradication regimens may have different effects on the gut microbiota. Few studies have analyzed the safety of high-dose dual therapy (HDDT) from a micro-ecological perspective. This study aimed to compare the impact of H. pylori eradication with HDDT and bismuth quadruple therapy (BQT) on gut microbiota.

Patients and methods

H. Pylori-infected treatment-naive patients were recruited and screened from September 2023 to April 2024 and randomly assigned to the HDDT group (esomeprazole 20 mg, amoxicillin 750 mg, qid, 14 days) or BQT group (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 600 mg, bid, 14 days). Fresh stool specimens were collected and stored before treatment and at week 2 and week 8 after treatment. The diversity and composition of the gut microbiota were compared and analyzed in both groups using 16 S rRNA gene sequencing.

Results

Forty-nine H. pylori positive patients were enrolled and randomly assigned to either the HDDT (n = 24) or the BQT group (n = 25) group. Compared with baseline, alpha and beta diversities significantly changed at week 2 after receiving BQT and did not recover fully at week 8. However, in the HDDT group, the diversities at week 2 changed mildly without statistical significance, compared to baseline. Additionally, a greater number of species had alterations in their abundances in the BQT group compared to the HDDT group at week 2. However, the abundances of these species were restored to their previous levels at week 8 in both the HDDT and BQT groups.

Conclusions

Compared to BQT, HDDT exerted less impact on the diversity and composition of the gut microbiota.

Clinical trial registration

ChiCTR2100053268.