Comparison of Efficacy of Four Different Helicobacter Pylori Eradication Regimens among Helicobacter Pylori Positive Peptic Ulcer Disease Patients
Publiée 2021-09-21
Mots-clés
- Helicobacter pylori,
- eradication rates,
- antibiotics and helicobacter pylori,
- rapid urease test
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Résumé
Introduction: Helicobacter pylori has high prevalence in Bangladesh and the eradication ratesof helicobacter pylori varies among different antibiotic combinations. It’s not known whichregimen is most effective. In this study effort was made to find out the efficacy of different drugregimens against helicobacter pylori in peptic ulcer disease patients. Methods: This is aprospective, open-label randomized study, done in the department of Gastroenterology,Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from March 2013 to March2014. A total of 112 patients underwent index endoscopy. Among them 52 patients werediagnosed as cases of peptic ulcer disease having Helicobacter Pylori infection by rapid ureasetest (RUT) and/or polymerase chain reaction (PCR). These 52 patients were randomized into 4groups to receive EAT (esomeprazole+amoxicillin+tetracycline), EAL(esomeprazole+amoxicillin+levofloxacin), ETL (esomeprazole+tetracycline+levofloxacin) andECA (esomeprazole+clarithromycin +amoxicillin) for 14 days. Follow up endoscopy and repeatRUT/PCR tests for helicobacter pylori was done after 2 months. Patients are declarederadicated who became negative for helicobacter pylori by both methods. Results: In total 47patients presented at two months follow up, which included 13 patients in the EAT group, 11 inthe EAL group, 11 in the ETL group and 12 in the ECA group. 72.7% of ETL group were curedand they were followed by EAL (63.6%). The cure rate for EAT and ECA stood at 53.8% and50% respectively. Chi-square value is 2.33 and p value is 0.5 which is not significant. Theeradication rates for H. pylori infection by intention-to-treat analysis for EAT was 53.8%(7/13), ECA 46.2% (6/13), EAL 53.8% (7/13) and ETL 61.5% (8/13) and P value is 0.94, whichis statistically non-significant. Conclusions: In this study each of the regimens fell considerablyshort of the 80% intention–to-treat eradication rate. On the other hand, present study resultsdid not bring any conclusion regarding which treatment regimen was superior or in other words there was no definitive statistically significant helicobacter pylori treatment regimenwhich was superior to others.
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