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Efficacy of vitamin C and E supplementation on Helicobacter pylori eradication rate with levofloxacin-based regimen

Yıl 2012, Cilt: 11 Sayı: 3, 117 - 120, 01.12.2012

Öz

Background and Aims: Currently, Helicobacter pylori cannot be eradicated in 100% of patients. In this study, we aimed to evaluate the efficacy of vitamin C and E supplementation on the Helicobacter pylori eradication rate with a levofloxacin-based regimen. Materials and Methods: Seventy patients with Helicobacter pylori -positive nonulcer dyspepsia were randomized into two groups. In group A, patients received lansoprazole 30 mg BID, amoxicillin 1000 mg BID, and levofloxacin 500 mg BID for 14 days; in group B, patients received lansoprazole 30 mg BID, amoxicillin 1000 mg BID, and levofloxacin 500 mg BID for 14 days in combination with vitamin C 500 mg BID and vitamin E 200 IU BID for 30 days. Helicobacter pylori eradication was evaluated with C14 urea breath test 4-6 weeks after the completion of therapy. Results: All patients in both groups completed the therapy. Helicobacter pylori eradication was achieved in 23 of 35 patients (65.8%) in group A and 27 of 35 (77.2%) in group B. The difference was not statistically significant (p=0.404). Conclusions: Helicobacter pylori eradication rates of both regimens were superior to that of standard triple therapy. The eradication rate of levofloxacin-based regimen plus vitamins C and E was close to the acceptable 80% eradication rate. The results of the present study revealed that adjuvant therapies such as vitamins C and E should be added to the eradication regimens.

Kaynakça

  • Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection. The Maas- tricht-III 2007 Consensus Report. Gut 2007;56:772-81.
  • Sezikli M, Çetinkaya ZA, Güzelbulut F, et al. Supplementing vita- mins C and E to standard triple therapy for the eradication of He- licobacter pylori. J Clin Pharm Ther 2012;37:282-5.
  • Sezikli M, Cetinkaya ZA, Güzelbulut F, et al. Efficacy of vitamins supplementation to therapy on Helicobacter pylori eradication in patients with low antioxidant capacity. Clin Res Hepatol Gastroen- terol 2011;35:745-9.
  • Kadayifci A, Buyukhatipoglu H, Cemil Savas M, Simsek I. Eradicati- on of Helicobacter pylori with triple therapy: an epidemiologic analysis of trends in Turkey over 10 years. Clin Ther 2006;28:1960- 6.
  • Göral V, Zeyrek FY, Gül K. Helikobakter pilori enfeksiyonunda anti- biyotik direnci. T Klin Gastroenterohepatol Derg 2000;11:87-92.
  • Siavoshi F, Saniee P, Latifi-Navid S, et al. Increase in resistance ra- tes of H. pylori isolates to metronidazole and tetracycline--compa- rison of three 3-year studies. Arch Iran Med 2010;13:177-87.
  • Saracino IM, Zullo A, Holton J, et al. High prevalence of primary antibiotic resistance in Helicobacter pylori isolates in Italy J. Gas- trointestin Liver Dis 2012;21:363-5.
  • Cağdaş U, Otağ F, Tezcan S, et al. Detection of Helicobacter pylo- ri and antimicrobial resistance in gastric biopsy specimens. Mikro- biyol Bul 2012;46:398-409.
  • B.Yasar,E. Abut,H. Kayadibi, et al. Efficacy of probiotics in Helico- bacter pylori eradication therapy. Turk J Gastroenterol 2010;21: 212-7.
  • Sezikli M, Cetinkaya ZA, Sezikli H, et al. Oxidative stress in Helico- bacter pylori infection: does supplementation with vitamins C and E increase the eradication rate? Helicobacter 2009;14:280-5.
  • Zojaji H, Talaie R, Mirsattari D, et al. The efficacy of Helicobacter pylori eradication regimen with and without vitamin C supplemen- tation. Dig Liver Dis 2009;41:644-7.
  • Kaboli SA, Zojaji H, Mirsattari D, et al. Effect of addition of vita- min C to clarithromycin- amoxicillin-omeprazol triple regimen on Helicobacter pylori eradication. Acta Gastroenterol Belg 2009;72: 222-4.
  • Halliwell B, Gutteridge JM. Lipid peroxidation, oxygen radicals, cell damage, and antioxidant therapy. Lancet 1984;1:1396-7.
  • Halliwell B, Gutteridge JM eds. Free Radicals in Biology and Medi- cine, 3rdedn. Oxford, UK: Oxford Science Publications, 2000.
  • Naito Y, Yoshikawa T. Molecular and cellular mechanisms involved in Helicobacter pylori-induced inflammation and oxidative stress. Free Radic Biol Med 2002;33:323-36.
  • Sezikli M, Çetinkaya ZA, Güzelbulut F, et al. Supplementing vita- mins C and E to standard triple therapy for the eradication of He- licobacter pylori. J Clin Pharm Ther 2012;37:282-5.
  • Güliter S, Keleş H, Ozkurt ZN, et al. Can lansoprazole, amoxicillin, and clarithromycin combination still be used as a first-line therapy for eradication of helicobacter pylori? Turk J Gastroenterol 2005; 16:29-33.
  • Hung KH, Sheu BS, Chang WL, et al. Prevalence of primary fluoro- quinolone resistance among clinical isolates of Helicobacter pylori at a University Hospital in Southern Taiwan. Helicobacter 2009;14: 61-5.
  • Bogaerts P, Berhin C, Nizet H, et al. Prevalence and mechanisms of resistance to fluoroquinolones in Helicobacter pylori strains from patients living in Belgium. Helicobacter 2006;11:441-5.
  • Yu C, Li L, Chen W, et al. Levofloxacin susceptibility testing for He- licobacter pylori in China: comparison of E-test and disk diffusion method. Helicobacter 2011;16:119-23.
  • Erdoğan AF, Abacı K, Serin E, et al. Birinci tercih Helikobakter pilo- ri eradikasyon tedavileri alarm mı veriyor? Akademik Gastroenterol Dergisi 2009;8:59-62.
  • Aydın Y, Nazlıgül Y, Yeniova AÖ, et al. The efficacy of levofloxacin- based triple therapy for first-line Helicobacter pylori eradication Dicle Med J 2011;38:197-201.
  • Li G, Li L, Yu C, Chen L. Effect of vitamins C and E supplementati- on on Helicobacter pylori eradication: a meta-analysis. Br J Nutr 2011;106:1632-7.
  • Güzelbulut F, Sezikli M, Cetinkaya ZA, et al. 7 günlük standard üç- lü tedaviye C ve E vitamini eklenmesi Helikobakter pilori eradikas- yon oranını arttırır. Akademik Gastroenteroloji Dergisi 2010;9:60- 3.

Helikobakter pilori eradikasyonunda levofloksasin bazl› rejime C ve E vitamini eklemenin eradikasyon üzerine etkileri

Yıl 2012, Cilt: 11 Sayı: 3, 117 - 120, 01.12.2012

Öz

Giriş ve Amaç: Günümüzde Helikobakter pilori hastaların %100'ünde eradike edilememektedir. Bu çalışmanın amacı levoşoksasin bazlı tedaviye vitamin C ve E eklemenin Helikobakter pilori eradikasyon oranları üzerine etkisini araştırmaktır. Gereç ve Yöntem: Helikobakter pilori pozitif nonülser dispepsili 70 hasta 2 gruba randomize edildi. Grup A'daki hastalara 14 günlük lansoprazol 30 mg 2x1, amoksisilin 1000 mg 2x1 ve levoşoksasin 500 mg 1x1; grup B'deki hastalara 14 günlük lansoprazol 30 mg 2x1, amoksisilin 1000 mg 2x1 ve levoşoksasin 500 mg 1x1 ile birlikte 30 günlük vitamin C 500 mg 2x1 ve vitamin E 200 IU 2x1 verildi. Helikobakter pilori eradikasyonu tedavi bitiminden 4-6 hafta sonra C14 üre nefes testi ile de¤erlendirildi. Bulgular: Her 2 grupta da tüm hastalar tedaviyi tamamladı. Grup A'daki 35 hastanın 23'ünde (%65.8), grup B'deki 35 hastanın 27'sinde (%77.2) Helikobakter pilori eradikasyonu elde edildi. 2 grup arasındaki fark istatistiksel olarak anlamlı de¤ildi (p=0.404). Sonuç: Her 2 rejim ile elde edilen Helikobakter pilori eradikasyon oranları literatürde bildirilen oranlardan daha yüksektir. Levoşoksasin bazlı tedavi ile birlikte vitamin C ve E verilmesi ile elde edilen eradikasyon oranı kabul edilebilir %80'lik orana yakı ndı. Bu çalışmanın sonucu eradikasyon rejimlerine vitamin C ve E gibi ajanların eklenmesi eradikasyon oranlarını artırabilir.

Kaynakça

  • Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection. The Maas- tricht-III 2007 Consensus Report. Gut 2007;56:772-81.
  • Sezikli M, Çetinkaya ZA, Güzelbulut F, et al. Supplementing vita- mins C and E to standard triple therapy for the eradication of He- licobacter pylori. J Clin Pharm Ther 2012;37:282-5.
  • Sezikli M, Cetinkaya ZA, Güzelbulut F, et al. Efficacy of vitamins supplementation to therapy on Helicobacter pylori eradication in patients with low antioxidant capacity. Clin Res Hepatol Gastroen- terol 2011;35:745-9.
  • Kadayifci A, Buyukhatipoglu H, Cemil Savas M, Simsek I. Eradicati- on of Helicobacter pylori with triple therapy: an epidemiologic analysis of trends in Turkey over 10 years. Clin Ther 2006;28:1960- 6.
  • Göral V, Zeyrek FY, Gül K. Helikobakter pilori enfeksiyonunda anti- biyotik direnci. T Klin Gastroenterohepatol Derg 2000;11:87-92.
  • Siavoshi F, Saniee P, Latifi-Navid S, et al. Increase in resistance ra- tes of H. pylori isolates to metronidazole and tetracycline--compa- rison of three 3-year studies. Arch Iran Med 2010;13:177-87.
  • Saracino IM, Zullo A, Holton J, et al. High prevalence of primary antibiotic resistance in Helicobacter pylori isolates in Italy J. Gas- trointestin Liver Dis 2012;21:363-5.
  • Cağdaş U, Otağ F, Tezcan S, et al. Detection of Helicobacter pylo- ri and antimicrobial resistance in gastric biopsy specimens. Mikro- biyol Bul 2012;46:398-409.
  • B.Yasar,E. Abut,H. Kayadibi, et al. Efficacy of probiotics in Helico- bacter pylori eradication therapy. Turk J Gastroenterol 2010;21: 212-7.
  • Sezikli M, Cetinkaya ZA, Sezikli H, et al. Oxidative stress in Helico- bacter pylori infection: does supplementation with vitamins C and E increase the eradication rate? Helicobacter 2009;14:280-5.
  • Zojaji H, Talaie R, Mirsattari D, et al. The efficacy of Helicobacter pylori eradication regimen with and without vitamin C supplemen- tation. Dig Liver Dis 2009;41:644-7.
  • Kaboli SA, Zojaji H, Mirsattari D, et al. Effect of addition of vita- min C to clarithromycin- amoxicillin-omeprazol triple regimen on Helicobacter pylori eradication. Acta Gastroenterol Belg 2009;72: 222-4.
  • Halliwell B, Gutteridge JM. Lipid peroxidation, oxygen radicals, cell damage, and antioxidant therapy. Lancet 1984;1:1396-7.
  • Halliwell B, Gutteridge JM eds. Free Radicals in Biology and Medi- cine, 3rdedn. Oxford, UK: Oxford Science Publications, 2000.
  • Naito Y, Yoshikawa T. Molecular and cellular mechanisms involved in Helicobacter pylori-induced inflammation and oxidative stress. Free Radic Biol Med 2002;33:323-36.
  • Sezikli M, Çetinkaya ZA, Güzelbulut F, et al. Supplementing vita- mins C and E to standard triple therapy for the eradication of He- licobacter pylori. J Clin Pharm Ther 2012;37:282-5.
  • Güliter S, Keleş H, Ozkurt ZN, et al. Can lansoprazole, amoxicillin, and clarithromycin combination still be used as a first-line therapy for eradication of helicobacter pylori? Turk J Gastroenterol 2005; 16:29-33.
  • Hung KH, Sheu BS, Chang WL, et al. Prevalence of primary fluoro- quinolone resistance among clinical isolates of Helicobacter pylori at a University Hospital in Southern Taiwan. Helicobacter 2009;14: 61-5.
  • Bogaerts P, Berhin C, Nizet H, et al. Prevalence and mechanisms of resistance to fluoroquinolones in Helicobacter pylori strains from patients living in Belgium. Helicobacter 2006;11:441-5.
  • Yu C, Li L, Chen W, et al. Levofloxacin susceptibility testing for He- licobacter pylori in China: comparison of E-test and disk diffusion method. Helicobacter 2011;16:119-23.
  • Erdoğan AF, Abacı K, Serin E, et al. Birinci tercih Helikobakter pilo- ri eradikasyon tedavileri alarm mı veriyor? Akademik Gastroenterol Dergisi 2009;8:59-62.
  • Aydın Y, Nazlıgül Y, Yeniova AÖ, et al. The efficacy of levofloxacin- based triple therapy for first-line Helicobacter pylori eradication Dicle Med J 2011;38:197-201.
  • Li G, Li L, Yu C, Chen L. Effect of vitamins C and E supplementati- on on Helicobacter pylori eradication: a meta-analysis. Br J Nutr 2011;106:1632-7.
  • Güzelbulut F, Sezikli M, Cetinkaya ZA, et al. 7 günlük standard üç- lü tedaviye C ve E vitamini eklenmesi Helikobakter pilori eradikas- yon oranını arttırır. Akademik Gastroenteroloji Dergisi 2010;9:60- 3.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Mesut Sezikli Bu kişi benim

Züleyha Akkan Çetinkaya Bu kişi benim

Göktuğ Şirin Bu kişi benim

Fatih Güzelbulut Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2012
Yayımlandığı Sayı Yıl 2012 Cilt: 11 Sayı: 3

Kaynak Göster

APA Sezikli, M., Çetinkaya, Z. A., Şirin, G., Güzelbulut, F. (2012). Helikobakter pilori eradikasyonunda levofloksasin bazl› rejime C ve E vitamini eklemenin eradikasyon üzerine etkileri. Akademik Gastroenteroloji Dergisi, 11(3), 117-120.

test-5