Helicobacter pylori Eradication Rates in Slovenia in the Period from 2017 to 2019: Data from the European Registry on H. pylori Management

Dig Dis. 2021;39(4):318-324. doi: 10.1159/000512506. Epub 2020 Oct 23.


Background: Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in the world, affecting over 50% of the world's population. H. pylori is a grade I carcinogen, responsible for the development of 89% of noncardia gastric cancers. In the present study, we analyzed the data for H. pylori eradication treatments in Slovenia after the 3rd national recommendations were implemented.

Patients and methods: Slovenia is part of the European Registry on H. pylori Management since the Registry was launched in 2013. Data were collected at Asociación Española de Gastroenterología-Research Electronic Data Capture electronic case report form from September 2017 to December 2019. H. pylori eradication treatment was assessed by modified intention-to-treat (mITT) and per-protocol analyses.

Results: Overall, 853 patients from 3 medical institutions were included. Effectiveness with first-line 14-day triple therapy with a proton-pomp-inhibitor (PPI), clarithromycin 500 mg, amoxicillin 1,000 mg, all BID, was 93% by mITT (714 patients). In patients allergic to penicillin, first-line 14-day triple therapy with PPI-clarithromycin-metronidazole achieved 83% effectiveness by mITT (35 patients). Second-line 14-day triple therapy with a PPI-amoxicillin-levofloxacin achieved 89% mITT eradication rate (51 patients). Second-line therapy with the 10-day three-in-one single capsule containing bismuth-tetracycline-metronidazole achieved optimal effectiveness (100% mITT) in 10 patients (p = 0.02).

Conclusions: Slovenia is a country with <15% H. pylori resistance to clarithromycin. Triple therapy with a PPI plus 2 antibiotics during 14 days reported optimal effectiveness (over 90%). Ten-day quadruple-bismuth second-line therapy had better results than 14-day triple therapy with levofloxacin.

Keywords: Eradication treatment; Helicobacter pylori; Registry; Slovenia.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Bismuth / therapeutic use
  • Clarithromycin / therapeutic use
  • Disease Eradication / methods
  • Disease Eradication / statistics & numerical data*
  • Drug Therapy, Combination
  • Female
  • Health Plan Implementation
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / microbiology
  • Helicobacter pylori*
  • Humans
  • Intention to Treat Analysis
  • Levofloxacin / therapeutic use
  • Male
  • Metronidazole / therapeutic use
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use*
  • Registries
  • Slovenia / epidemiology


  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Metronidazole
  • Levofloxacin
  • Amoxicillin
  • Clarithromycin
  • Bismuth