İKİNCİ BASAMAK DEVLET HASTANESİNDE İKİ FARKLI HELICOBACTER PYLORI TEDAVİ REJİMİNİN ETKİNLİĞİNİN DEĞERLENDİRİLMESİ.

Year 2023, , 32 - 38, 28.03.2023

Ferit Çelik , Ali Şenkaya

https://doi.org/10.56150/tjhsl.1246441

Abstract

Öz (tr)
Amaç: Helicobakter pylori (H. pylori); dünya nüfusunun yarısından fazlasını enfekte eden ve Dünya Sağlık Örgütü tarafından sınıf 1 kanserojen olarak tanımlanan bir bakteridir. Bu çalışmada amaç ikinci basamak devlet hastanesinde, H. pylori pozitifliği saptanan ve levofloksasin içeren modifiye sıralı tedavi rejimi veya bizmut bazlı dörtlü tedavi rejimi uygulanan hastalarda tedavilerin etkinliğinin karşılaştırılmasıdır.
Yöntem: Bu çalışma, Nisan 2021 ile Nisan 2022 tarihleri arasında H. pylori eradikasyon tedavisi verilip, bu tedaviyi tolere eden 167 hastanın retrospektif analizini içermektedir. Çalışmaya dahil edilen hastalar aldıkları tedavi rejimine göre iki gruba ayrıldı. Levofloksasin içeren modifiye sıralı tedavi rejimi (7 gün amoksisilin 1 gr 2x1, pantoprazol 40 mg 2x1, ardından 7 gün pantoprazol 40 mg 2x1, metronidazol 500 mg 3x1, levofloksasin 500 mg 1x1) verilen hastalar Grup 1, bizmut bazlı dörtlü tedavi (14 gün pantoprazol 40 mg 2x1, bizmut subsalisilat 262 mg 2x2, metronidazol 500 mg 3x1, tetrasiklin 500 mg 4x1) verilen hastalar Grup 2 olarak belirlendi.
Bulgular: H. pylori tedavisini toplam 14 (grup 1’de bir ve grup 2’de 13) hasta tolere edemedi, tedaviyi tamamlayan toplam 167 hastanın, grup 1’de 83 (%90,2)'ünde, grup 2’de 70 (%93,3)'inde eradikasyon sağlandı. Her iki tedavi protokolünde de eradikasyon başarı oranları açısından istatistiksel anlamlı farklılık saptanmadı (p=,470). Tedavi grupları arasında yaş, cinsiyet, endoskopi endikasyonu, endoskopik tanılar, patolojik bulgular, eradikasyon endikasyonları açısından anlamlı farklılık yoktu.
Sonuç: Çalışmamızda saptanan eradikasyon başarı oranları dikkate alındığında, levofloksasin içeren modifiye sıralı tedavi rejiminin, ülkemizde birinci basamak tedavide bizmut bazlı tedaviye alternatif veya bizmut bazlı tedaviyi tolere edemeyen hastalarda ikinci sıra tedavi olabileceğini desteklemektedir. Yine de, levofloksasin içeren modifiye sıralı tedavi ile ilgili daha fazla çalışmaya ihtiyaç duyulmaktadır.

Keywords

Bizmut, eradikasyon, Helicobakter pylori, levofloksasin

Supporting Institution

yok

Project Number

yok

Evaluation of the efficacy of two different Helicobacter pylori eradication regimens at a secondary public health care center

Abstract

Objective: Helicobacter pylori (H. pylori) is a bacterium that infects more than half of the world's population and is defined as a class 1 carcinogen by the World Health Organization. The aim of this study is to compare the efficacy of treatments in patients with H. pylori positivity who were treated with a modified sequential treatment regimen containing levofloxacin or a bismuth-based quadruple treatment regimen in a secondary state hospital. Method: This study includes retrospective analysis of 167 patients who received and tolerated H. pylori eradication therapy between April 2021 and April 2022. The patients included in the study were divided into two groups according to the treatment regimen they received. Patients given a modified sequential treatment regimen containing levofloxacin (amoxicillin 1 g 2x1, pantoprazole 40 mg 2x1 for 7 days, followed by pantoprazole 40 mg 2x1 for 7 days, metronidazole 500 mg 3x1, levofloxacin 500 mg 1x1) Group 1 and the patients who were given bismuth-based quadruple therapy (14 days pantoprazole 40 mg 2x1, bismuth subsalicylate 262 mg 2x2, metronidazole 500 mg 3x1 and tetracycline 500 mg 4x1) were determined as Group 2.
Results: A total of 14 patients (one in group 1 and 13 in group 2) could not tolerate H.pylori treatment, and eradication was achieved in 83 (90.2%) in group 1 and 70 (93.3%) in group 2 of 167 patients who completed the treatment. There was no statistically significant difference in eradication success rates in both treatment protocols (p=.470). There was no significant difference between the treatment groups in terms of age, gender, indications for endoscopy, endoscopic diagnoses, pathological findings, and eradication indications.
Conclusion: Considering the eradication success rates found in our study, it supports that the modified sequential treatment regimen containing levofloxacin may be an alternative to bismuth-based treatment in the first-line treatment in our country, or a second-line treatment in patients who cannot tolerate bismuth-based treatment. However, further studies on modified sequential therapy containing levofloxacin are needed.

Keywords

Bismuth, eradication, Helicobacter pylori, levofloxacin

Project Number

yok

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