Effectiveness of eradication therapy for Hp infection of residents of Perm and the Perm region

Abstract

Purpose: to evaluate the effectiveness of eradication therapy for Hp infection in Perm and the Perm region. Materials and methods: a retrospective analysis of 88 case histories of patients who underwent eradication of Hp infection was carried out at the Perm Medical Center (GASTROCENTER). Primary infection with H. pylori was confirmed by: serological blood test or determination of Hp antigen in feces, rapid urease test, and C13 urease breath test. Hp eradication therapy regimens, depending on the source of prescription, included standard triple therapy with the addition of bismuth preparations for a period of 14 days (main group) or 7-10-day triple therapy (control group). Results and discussion: the main indications for Hp eradication were: chronic gastritis and gastroesophageal reflux disease. In the main group, all patients received Hp eradication therapy with the inclusion of: esomeprazole (emanera) 40 mg, amoxicillin 1000 mg, clarithromycin (fromilid) 50 mg and bismuth tripotassium dicitrate (ulcavis) 240 mg twice a day for 14 days. The control group included patients who received Hp eradication schemes with various proton pump inhibitors, amoxicillin and clarithromycin or metronidazole or levofloxacin or even rifaximin for 7 or 10 days. Adverse events: abdominal pain and diarrhea occurred in both groups. Patients of the main group complained about bitterness in the mouth, where all patients received clarithromycin. Approximately the same small number of patients complained of nausea. With a differentiated assessment by groups, in the main group, Hp eradication was highly effective and reached 93%, while in the control group it was significantly lower and did not exceed 48% (p=0,00087) Conclusions: modern detection of Hp infection and its eradication is an effective approach to the prevention of atrophic gastritis, gastric cancer and peptic ulcer of the stomach and duodenum. The “gold” standard for diagnosing Hp infection is the 13C-urease breath test. For residents of Perm and the Perm Territory, it is recommended to use Hp eradication with the appointment of a 14-day regimen with the inclusion of esomeprazole (Emaner), clarithromycin (Fromilide), amoxicillin and bismuth tripotassium dicitrate (Ulkavis) as the first line of therapy.