Comparison of Classical Triple Therapy and Classical Triple + Bismuth Therapy for Eradication of Helicobacter Pylori

Abstract

Background: Comparison of the Helicobacter Pylori (HP) eradication rate between classicaltriple therapy and bismuth added into the classical therapy on the HP positive patients with peptic ulcer is aimed.

Materials and Methods: Sixty patients whom gastric and/or duodenal ulcer (peptic ulcer) was detected by endoscopy as well as who presented positive results in any of histopathology, urea breath test or HP antigen in the stool between January 2012 and January 2013 were included into the study prospectively. Classical triple therapy was applied to the patients in Group 1 (n=30) whereas classical triple therapy +bismuth were applied to the patients in group 2 (n=30) Therapeutic efficiency of both groups were compared statistically after 3 months.

Results: HP antigen detection in the stool revealed eradication rates of 83.3 % and 73.3 % in Group 1 and Group 2, respectively. There was not any difference for therapeutic efficiency between both groups by the evaluation through HP antigen detection in the stool (p=0.532). Urea breath test determined eradication rates of 56.7 % and 53.3 % in Group 1 and Group 2, respectively. No difference was detected for therapeutic efficiency between both groups by the evaluation through urea breath test (p=0.795). Eradication rates by HP antigen test were more than rates by urea breath test for all patients treated; this difference was statistically significant (p=0.011).

Conclusion: No difference was detected between classical triple therapy and classical triple therapy + bismuth therapy in terms of eradication. Therefore, the therapy should be planned by considering clarithromycin resistance. Furthermore, a significant difference was detected between Hp antigen in the stool and urea breath test for evaluation of therapeutic efficiency after the therapy and rate of eradication by HP antigen detection in the stool seems higher.

Key words: Helicobacter pylori, Classical triple therapy, Bismuth

Helikobakter Pilori Eradikasyonunda Klasik ÜçlüTedavi İle Klasik Üçlü+Bizmut Tedavisinin Karşılaştırılması

Abstract

Amaç: Kliniğimize başvuran peptik ülserli, Helikobakter Pilori (HP) pozitif hastalarda klasik üçlü tedavi verilen hastalarla klasik üçlü tedaviye bizmut eklenen hastalar arasındaki HP eradikasyon oranının karşılaştırılması amaçlanmaktadır.

Materyal ve Metod: Ocak 2012- Ocak 2013 tarihleri arası prospektif olarak, endoskopilerinde gastrik ve/veya duodenal ülser (peptik ülser) saptanan, histopatoloji, üre nefes testi ya da dışkıda HP antijeni sonuçlarından herhangi birinde pozitiflik saptanan 60 hasta ardışık olarak çalışmaya alındı. Grup 1 hastalara (n=30) klasik üçlü tedavi, grup 2 hastalara (n=30) klasik üçlü tedavi+bizmut tedavileri uygulandı. 3 ay sonra her iki grubun tedavi etkinliği istatistiksel olarak karşılaştırıldı.

Bulgular: Dışkıda HP antijeni saptanması testi ile grup 1’ de %83,3, grup 2’ de %73,3 eradikasyon olduğu belirlendi. Dışkıda HP antijeni saptanması ile yapılan değerlendirmede her iki grup arasında tedavi etkinliği açısından herhangi bir fark saptanmadı (p=0,532). Üre nefes testi ile grup 1’ de %56,7, grup 2’ de %53,3 eradikasyon olduğu belirlendi. Üre nefes testi ile yapılan değerlendirmede her iki grup arasında tedavi etkinliği açısından herhangi bir fark saptanmadı (p=0,795). Tüm tedavi alanlarda dışkıda HP antijeni testi ile eradike olma oranı üre nefes testine göre daha fazla görüldü, istatiksel olarak anlamlı idi (p=0,011).

Sonuç: Klasik üçlü tedavi ile klasik üçlü tedavi+ bizmut tedavisi arasında eradikasyon açısından herhangi bir farklılık saptanmamıştır. Bu yüzden klaritromisin direnci göz önünde bulundurularak seçilecek tedavi ona göre belirlenmelidir. Ayrıca tedavi sonrası etkinliği değerlendirmede dışkıda HP antijeni testi ile üre nefes testi arasında anlamlı fark bulunup dışkıda HP antijeni ile eradikasyon oranı daha yüksek görünmektedir.

Keywords

• Helikobakter pilori,Klasik üçlü tedavi,Bizmut

References

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