Yıl: 2020 Cilt: 21 Sayı: 2 Sayfa Aralığı: 111 - 116 Metin Dili: İngilizce DOI: 10.4274/meandros.galenos.2019.08831 İndeks Tarihi: 06-05-2021

The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication

Öz:
Objective: New therapy regimens are needed for Helicobacter pylori (H. pylori) eradication because of increased resistance to the commonly used antibiotics. This study aimed to compare the efficacy of bismuth quadruple therapy versus sequential therapy for H. pylori eradication.Materials and Methods: Patients who presented with dyspepsia complaints and were diagnosed with H. pylori infection by histopathologic examination of biopsies obtained by gastroscopy were evaluated retrospectively. Two hundred and five patients who received bismuth-based quadruple therapy and sequential therapy for H. pylori eradication were included in the study. Bismuth-based quadruple therapy group were given pantoprazole 2x40 mg, bismuth subcitrate 4x300 mg, amoxicillin 2x1000 mg and metronidazole 3x500 mg for 14 days. In the bismuthbased sequential therapy group, the protocol was as follows; pantoprazole 2x40 mg (14 days), bismuth subcitrate 4x300 mg (14 days), amoxicillin 2x1000 mg (first 7 days), metronidazole 3x500 mg (second 7 days) and levofloxacin 1x500 mg (second 7 days). Eradication was determined by stool H. pylori Antigen test six weeks after the treatment.Results: A total of 102 patients in group 1 and 91 patients in group 2 completed the treatment and there was no significant difference between the two groups (p=0.310). H. pylori eradication rate showed no significant difference between the two groups (p=0.093), while group 1 attained a better eradication rate than group 2 on intention-to-treat, which was statistically significant (p=0.033).Conclusion: We achieved better eradication rates with bismuth-based quadruple therapy compared to the sequential therapy. We recommend bismuth-based quadruple regimen as the first-line eradication therapy to avoid drug incompatabilities seen during the sequential regime.
Anahtar Kelime:

Helikobakter pilori Eradikasyonunda Bizmutlu Dörtlü Tedavi ile Bizmutlu Ardışık Tedavinin Etkinliği

Öz:
Amaç: Helikobakter pilori (H. pilori) eradikasyon tedavisinde kullanılanantibiyotiklere karşı direncin artması nedeniyle yeni tedavi rejimlerine ihtiyaçduyulmaktadır. Bu çalışmada, H. pilori eradikasyonunda bizmutlu dörtlü tedavi ilebizmutlu ardışık tedavinin etkinliğini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Dispepsi yakınması ile başvuran, yapılan gastroskopi ile alınanbiyopsilerde histolojik inceleme sonrasında H. pilori saptanan hastalar retrospektif olarak değerlendirildi. Eradikasyon tedavisi olarak bizmutlu dörtlü tedavi ve bizmutlu ardışık tedavi alan 231 hasta çalışmaya alındı.Bizmutlu dörtlü tedavi alan gruba; 14 gün boyunca pantoprazol 2x40 mg, bizmut subsitrate 4x300 mg, amoksisilin 2x1000 mg,metronidazol 3x500 mg (14 gün) verilmişti. Bizmutlu ardışık tedavi alan gruba; pantoprazol 2x40 mg (14 gün), bizmut subsitrate4x300 mg (14 gün), amoksisilin 2x1000 mg (ilk 7 gün), metronidazol 3x500 mg (ikinci 7 gün), levofloksasin 1x500 mg (ikinci 7 gün)verilmişti. Eradikasyon, tedaviden altı hafta sonra gaitada H. pilori Antijen testi ile ölçüldü. Bulgular: Grup 1’de 102 hasta, grup 2’de 91 hasta tedaviyi tamamlamış ve her iki grup arasında anlamlı bir fark bulunmamıştır(p=0,310). Her iki grup arasında protokol başına eradikasyon oranı açısından anlamlı bir fark bulunmamış (p=0,093), grup 1 rejimiintention-to-treat’de grup 2’ye göre daha iyi eradikasyon oranına ulaşmış ve istatistiksel olarak anlamlı bulunmuştur (p=0,033). Sonuç: Bizmut bazlı dörtlü tedavi ile ardışık tedaviye oranla daha iyi bir eradikasyon oranlarına ulaştık. Ardışık tedavi sırasındagörülebilen ilaç uyumsuzluğu nedeniyle birinci basamak eradikasyon tedavisinde bizmut bazlı dörtlü tedavi rejiminin kullanılmasınıönermekteyiz.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Coskun A, ÇELİK M, KANDEMİR A (2020). The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. , 111 - 116. 10.4274/meandros.galenos.2019.08831
Chicago Coskun Adil,ÇELİK MUSTAFA,KANDEMİR ALTAY The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. (2020): 111 - 116. 10.4274/meandros.galenos.2019.08831
MLA Coskun Adil,ÇELİK MUSTAFA,KANDEMİR ALTAY The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. , 2020, ss.111 - 116. 10.4274/meandros.galenos.2019.08831
AMA Coskun A,ÇELİK M,KANDEMİR A The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. . 2020; 111 - 116. 10.4274/meandros.galenos.2019.08831
Vancouver Coskun A,ÇELİK M,KANDEMİR A The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. . 2020; 111 - 116. 10.4274/meandros.galenos.2019.08831
IEEE Coskun A,ÇELİK M,KANDEMİR A "The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication." , ss.111 - 116, 2020. 10.4274/meandros.galenos.2019.08831
ISNAD Coskun, Adil vd. "The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication". (2020), 111-116. https://doi.org/10.4274/meandros.galenos.2019.08831
APA Coskun A, ÇELİK M, KANDEMİR A (2020). The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. Meandros Medical And Dental Journal, 21(2), 111 - 116. 10.4274/meandros.galenos.2019.08831
Chicago Coskun Adil,ÇELİK MUSTAFA,KANDEMİR ALTAY The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. Meandros Medical And Dental Journal 21, no.2 (2020): 111 - 116. 10.4274/meandros.galenos.2019.08831
MLA Coskun Adil,ÇELİK MUSTAFA,KANDEMİR ALTAY The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. Meandros Medical And Dental Journal, vol.21, no.2, 2020, ss.111 - 116. 10.4274/meandros.galenos.2019.08831
AMA Coskun A,ÇELİK M,KANDEMİR A The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. Meandros Medical And Dental Journal. 2020; 21(2): 111 - 116. 10.4274/meandros.galenos.2019.08831
Vancouver Coskun A,ÇELİK M,KANDEMİR A The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication. Meandros Medical And Dental Journal. 2020; 21(2): 111 - 116. 10.4274/meandros.galenos.2019.08831
IEEE Coskun A,ÇELİK M,KANDEMİR A "The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication." Meandros Medical And Dental Journal, 21, ss.111 - 116, 2020. 10.4274/meandros.galenos.2019.08831
ISNAD Coskun, Adil vd. "The Efficacy of Bismuth-basedQuadruple and Sequential Therapies inHelicobacter pylori Eradication". Meandros Medical And Dental Journal 21/2 (2020), 111-116. https://doi.org/10.4274/meandros.galenos.2019.08831