Background:The prevalence rate of gastric infections caused by Helicobacter pylori is different in between as well as within various countries, including Iran.Objectives:This study was aimed to evaluate the prevalence of H. pylori in Iranian adult patients with dyspepsia.Patients and Methods:A total of 548 patients with dyspepsia referred to Namazi Hospital, a referral center for gastrointestinal diseases in Shiraz, south of Iran, were evaluated in a cross-sectional study. The diagnosis of dyspepsia was based on clinical findings. Upper gastrointestinal endoscopy was performed for all the patients and two antral biopsies were taken from all the included ones. The patients were categorized based on the endoscopic findings, to four groups:normal,abnormal nonulcerative,ulcerative, andcombination of 2 and 3.Two positive test results (Gram staining, rapid urease test, and culture) was considered as a positive-definite H. pylori infection for each patient.Results:From the 548 included patients (238 males and 310 females), H. pylori was detected in 170 (31.2%). The mean age was 40.38 ± 15.39 years old. H. pylori infection was detected in 26.1% of male and 34.8% of female patients and its prevalence increased with age. Eighty three (48.8%) patients were positive for H. pylori infection, of which, 12.4% had normal and 36.4% had abnormal nonulcerative endoscopic findings; 17.1% of patients were ulcerative and 34.1% had ulcer with or without concurrent abnormality.Conclusions:Findings from this study showed a lower prevalence of H. pylori infection than other studies and its prevalence increased with age. There was no association between sex and infection. The most common endoscopic abnormality in H. pylori-positive patients was ulcerative lesion.

Background:Helicobacter pylori (H pylori) is a common gastric pathogen which is associated with chronic gastritis, peptic ulcer, and gastric cancer. It has worldwide distribution with higher incidence in developing countries. Gemifloxacin is a fluoroquinolone antibiotic with documented in vitro activity against H pylori. Considering that there is no clinical data to verify gemifloxacin efficacy in H pylori eradication, this pilot clinical trial was designed.Methods:This prospective pilot study was performed during February 2014 to February 2015. A regimen of gemifloxacin (320 mg single dose) plus twice daily doses of amoxicillin1g, bismuth 240 mg, and omeprazole 20 mg for 14 days were prescribed for H pylori infected patients in whom a first-line standard quadruple therapy (clarithromycin–amoxicillin–bismuth–omeprazole) had failed. To confirm H pylori eradication a 13C-urea breath test was performed 4 weeks after treatment.Compliance and incidence of adverse effects were evaluated by questionnaires.Results:A total of 120 patients were enrolled consecutively; out of which 106 patients achieved H pylori eradication; per-protocol and intention-to-treat eradication rates were 91.4% (95% CI: 85.5–97.6) and 88.3% (95% CI: 75.4–92.4) respectively. Three patients (2.5%) failed to take at least 80% of the drugs and excluded from the final analysis. Adverse effects were reported in 42% of patients, most commonly including nausea (15%) and diarrhea (13.3%), which was intense in 1 patient and led to the discontinuation of treatment. In total, 96.7% (116/120) of the patients took the medications correctly.Conclusion:This study revealed that gemifloxacin-containing quadruple therapy provides high H pylori eradication rate (≥90% PP cure rate), and this agent can be included in the list of second-line H pylori therapeutic regimens.