First-Line Therapy in Helicobacter pylori Eradication Therapy: Experience of a Surgical Clinic

Abstract

Objective: Helicobacter pylori (HP) is the world's most common infectious agent. Despite conventional therapy consisting of proton pump inhibitor (PPI), amoxicillin (AMO) and clarithromycin (CLA), approximately half of the patients remain infected. We compared the PPI-based triple therapy with quadruple treatment (BPMT) including bismuth citrate (BS), PPI, metronidazole (MET) and tetracycline (TET). Material and Methods: Forty-three patients who used triple therapy (LAC) consisting of lansoprazole (L), AMO and CLA and 42 patients who used quadruple therapy (BPMT) for 14 days between May 2008 and November 2013 were included in the study. The LAC group included patients who received 30 mg L 2x1, 1000 mg AMO 2x1, and 500 mg CLA 2x1 for 14 days, whereas the BPMT group was designed from patients who received 600 mg BS 2x1, 40 mg omeprazole (O) 2x1 or 30 mg L 2x1, 500 mg MET 3x1 and 500 mg TET 4x1. Results: Demographic characteristics and endoscopic findings were similar in both groups. The eradication rate was 53.4% in the LAC group and 78.5% in the BPMT group (p<0.05). Compliance problems and side effects were significantly higher in the BPMT group as compared to the LAC group (p<0.05). Conclusion: Due to high antibiotic resistance in Turkey, the efficacy of LAC treatment has reduced. The BPMT protocol should be kept in mind in the first line of treatment, since it provides a higher eradication rate.