Value of supplementing vitamin C to the triple therapy on the eradication rates of Helicobacter pylori infection

Several clinical studies have shown that higher prevalence of Helicobacter pylori infection is associated with low vitamin C (Vit C) level in serum. The aim of this study was to assess the effect of supplementation of Vit C on the eradication rates of clarithromycin‐based triple therapy for H. pylori infection. This study included 100 patients diagnosed with H. pylori gastritis using magnifying narrow‐band imaging endoscopy supported by stool antigen test. Patients were divided into two groups: Patients in group A (n = 50) received amoxicillin, clarithromycin, and esomeprazole for 2 weeks while patients in group B (n = 50) received Vit C for 4 weeks, in addition to amoxicillin, clarithromycin, and esomeprazole for 2 weeks. The eradication rates were assessed using per‐protocol (PP) and intention‐to‐treat (ITT) analysis. Our results revealed that, eradication was achieved in 31 (70.45%) of 44 patients by PP and 31 (62.%) of 50 by ITT analysis in group A, while in group B, eradication was achieved in 34 (73.91%) of 46 patients by PP and 34 (68%) of 50 by ITT analysis. However, when Vit C supplementation was added to the clarithromycin‐based triple therapy it was observed that there were no statistically significant differences between groups A and B (P = .663 in ITT analysis and P = .727 in PP analysis).Our results demonstrated that supplementing Vit C to clarithromycin‐based triple therapy did not provide an additional advantage for achieving significantly higher eradication rates for H. pylori‐related chronic gastritis and most likely to be preventive rather than curative.