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07-06-2012 | Gastroenterology | Article

Vitamins C and E could improve eradication of Helicobacter pylori


Free abstract

MedWire News: The addition of vitamins C and E to a standard triple-therapy regimen for treatment of Helicobacter pylori significantly improves disease eradication rates, report Turkish researchers.

One arm of their study included 30 days of vitamin C 500 mg and vitamin E 200 IU in addition to a standard 14-day treatment regimen of lansoprazole 30 mg plus amoxicillin 1000 mg plus clarithromycin 500 mg.

This resulted in almost double the rate of H. pylori eradication compared with the study arm without vitamin supplementation.

Akkan Çetinkaya (Kocaeli Derince Research and Education Hospital) and colleagues believe that the vitamins' antioxidant properties increased the efficacy of the antibiotics by decreasing oxidative stress in the gastric mucosa, thereby impairing the bacterial microenvironment, or strengthening the immune system by increasing total antioxidant capacity.

The team randomly assigned 200 H. pylori patients to receive the standard triple therapy regimen plus vitamins (group A), or triple therapy alone (group B).

Among the 195 patients who completed the study, eradication rates were significantly higher in group A (n=157) than group B (n=38) after treatment, at 82.5 versus 45.0% in the intention-to-treat analysis, and 84.0% versus 47.4% in the per-protocol analysis. The results did not vary significantly by gender, note Çetinkaya et al.

While some patients reported nausea and a metallic taste in the mouth, these adverse effects were mild and well tolerated, they add.

Eradication rates for this prevalent infection - approximately 50% of the world's population is infected with it vary worldwide, and are low in countries where "uncontrolled antibiotic use is common," writes the team in the Journal of Clinical Pharmacy and Therapeutics.

Adequate therapy regimens should provide an eradication rate of at least 80% without causing any adverse effects on antibiotic resistance, say the researchers, who maintain that this goal is unachievable with antibiotics alone.

Vitamin C prevents and decreases oxidation reactions, eliminates reactive oxygen species (ROS), caused by H. pylori, and decreases the amount of N-nitrosamines in gastric fluid, write the researchers. Vitamin E buffers ROS, and vitamin C subsequently deoxidizes vitamin E.

"Thus, vitamins C and E have additive effects," the team concludes.

By Sarah Guy

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