Vitamin D as an Adjuvant Therapy for Eradication of H. pylori. A Randomized Controlled Clinical Trial

Background: Helicobacter pylori shows high rate of antibiotic resistance and declining eradication rates; thus, a salvage therapy is needed. Vitamin D is known to have antimicrobial and immune modulatory properties. Observational studies linking Vitamin D serum levels to H pylori eradication have paved a way for interventional clinical trials. Aim: To study the effect of adding Vitamin D to the standard clarithromycin based triple therapy on eradication rates of H pylori. Subsidiary aim was to detect vitamin D serum levels among Egyptian Children infected with H pylori. Methods: A randomized controlled clinical trial including 200 children with an age range between 5-15 years, presenting to pediatric gastrointestinal endoscopy, and diagnosed as having H pylori infection based on histopathology of their gastric biopsy specimens, they were randomly allocated to 2 groups, one group received the standard clarithromycin based triple therapy, while the other group received 1000 IU Vitamin D 3 in addition to the triple therapy. Fecal antigen was done 1 month after stopping the medications to diagnose success of eradication. Results: The eradication rate of H pylori was significantly higher (82 %) among the group receiving Vitamin D supplementation , in comparison to the other group (51%). Also, Vitamin D intake was an independent factor for predicting the success of eradication (odds ratio: 5.08, CI: 2.51-10.98, P value=0.0001). Conclusion: Vitamin D supplementation improves eradication rates of H pylori among children especially at communities with prevalent Vitamin D deficiency.