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

Year 2019, , 484 - 487, 25.12.2019

Umut Sert , Çiğdem Cindoğlu , Ahmet Uyanıkoğlu

https://doi.org/10.35440/hutfd.585601

Cited By: 1

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

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