Comparison of the efficacy of proton pump inhibitors used in the eradication of Helicobacter pylori

Öz

Background and Aims: Although different therapy regimens are used for the eradication of Helicobacter pylori, an ideal therapy regimen has not yet been determined. The most commonly used and most effective therapy regimens consist of a proton pump inhibitor or bismuth plus 2 antibiotics for 7-14 days. We aimed to compare the efficacies of different PPIs in combination with the same antibiotics on the eradication of Helicobacter pylori. Materials and Methods: This study included 90 patients with Helicobacter pylori-positive non-ulcer dyspepsia. The patients were randomized into 3 groups. Patients in Group A received omeprazole 20 mg BID, those in Group B received pantoprazole 40 mg BID and those in Group C received rabeprazole 20 mg BID. All patients received amoxicillin 1000 mg BID plus clarithromycin 500 mg BID in combination with proton pump inhibitors. The duration of therapies was 14 days in all groups. Patients were tested with 14C-urea breath test for Helicobacter pylori eradication 4-6 weeks after completion of therapy. Results: The eradication rates in Groups A, B and C were 40%, 56.6%, and 63.3%, respectively. The difference between groups was not statistically significant (p=0.179). Conclusions: The antibacterial efficacy of proton pump inhibitors on Helicobacter pylori seems to be related to a decrease in the acidity of gastric juice. Our results show that the type of proton pump inhibitor does not affect Helicobacter pylori eradication rates.

Anahtar Kelimeler

• Helicobacter pylori, eradication, proton pump inhibitor

Helikobakter pilori eradikasyonunda kullanılan proton pompa inhibitörlerinin etkinliklerinin karşılaştırılması

Öz

Giriş ve Amaç: Helikobakter pilori tedavisinde pek çok tedavi rejimi önerilmekle birlikte halen optimal tedavi rejimi tanımlanamamıştır. Helikobakter pilori tedavisinde iki antibiyotik ile beraber proton pompa inhibitörü veya bizmut içeren ilaçların 7-14 gün kullanılması en fazla önerilen ve en etkili tedavi rejimleridir. Biz bu çalışmada farklı proton pompa inhibitörlerini aynı antibiyotiklerle kombine ederek eradikasyon etkinliklerini kıyaslamayı amaçladık. Gereç ve Yöntem: Üst gastrointestinal sistem endoskopisi sonrası biyopsi sonucu ile Helikobakter pilori pozitişiği saptanan 90 adet non-ülser dispepsi hastası çalışmaya alındı. Hastalar 3 gruba ayrıldı. Tüm gruplara klaritromisin 500 mg 2x1, amoksisilin 1 gr 2x1 sabit olmak üzere;1. gruba omeprazol 20 mg 2x1, 2. gruba pantoprazol 40 mg 2x1, 3. gruba ise rabeprazol 20 mg 2x1 ondört gün süre ile verildi. Ondört günlük tedavi bitiminden 4-6 hafta sonra C-14 üre nefes testi ile eradikasyon kontrolü yapıldı. Bulgular: Omeprazol grubunda %40, pantoprazol grubunda %56.6, rabeprazol grubunda ise %63.3 eradikasyon oranı sağlandı. Gruplar arasında istatistiksel olarak fark yoktu (p=0.179). Sonuç: Proton pompa inhibitörlerinin antibakteriyel etkisinin eradikasyonda minimal olduğunu, esas rollerinin antiasid aktivite olduğunu düşündürmektedir. Bu bulgular Helikobakter pilori eradikasyonunda proton pompa inhibitörü seçiminin eradikasyon üzerine bir etkisi olmadığı şeklinde yorumlanabilir.

Anahtar Kelimeler

• Helikobakter pilori, eradikasyon, proton pompa inhibitöru

Kaynakça

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