In an interview, Richard Peek, Jr., MD, of Vanderbilt University Medical Center, Asheville, NC, discussed the implications of the study findings in an interview with this news organization.

Are you moving away from triple therapy as first-line given resistance patterns?

Dr. Peek: This study reinforces recent guidelines focused on optimal treatment strategies for the eradication of H. pylori. When empiric treatment decisions need to be made, triple therapy should not be used as a first-line regimen. The strongest data currently available support the use of Bismuth quadruple therapy for 14 days as the optimal first-line treatment for H. pylori when antibiotic susceptibility results are not available.

The statin signal is intriguing but observational. What are your thoughts on potential mechanisms that might explain this association? And should this observational finding influence current practice?

Dr. Peek: The observation that statin use enhances H. pylori treatment efficacy has been previously reported. However, a meta-analysis evaluating the effect of statins on eradication rates in multiple studies found no significant benefit, although the number of studies included was small. Putative mechanisms through which statins may augment treatment efficacy include anti-inflammatory, immunomodulatory, or antimicrobial effects. However, due to the limited amount of data available, it cannot be recommended at the present time to include statins as adjuvants to anti-H. pylori eradication regimens.