ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 24 of 57
JMBS 2020, 5(1): 167–171
Clinical Medicine

Antimicrobial Therapy in Conditions of Helicobacter Pylori–Infection

Nemchenko O. O. 1, Shykula R. G. 1, Panas M. I. 2, Tymchuk I. V. 1, Panas M. A. 1

Helicobacter pylori–infection is one of the main factors that leads to the development of chronic diseases of the upper gastrointestinal tract. The article considers the problems of antimicrobial therapy in patients with chronic diseases of the gastrointestinal tract. Material and methods. In total, 98 patients infected with H. pylori were involved in the study. Infection was determined by urease test and immunochromatography method for the detection of antigens of the pathogen in the faeces. Diagnosis of patients was established on the basis of medical history and the endoscopic and histological methods. When H. pylori infection is diagnosed and we do not know its sensitivity to antibiotics therefore, it is recommended to administer various antibiotics at high doses for two weeks. Results and discussion. The patients were given three treatment regimens: group І had triple therapy with pantoprazole 20 mg twice a day, clarithromycin 1 g per day, amoxicilina 2 g / day; group II had quadruple therapy (QТ1) with pantoprazole 20 mg twice a day, clarithromycin 1 g per day, amoxicilina 2 g / day, metronidazole 1500 g once a day and additionally with Saccharomyces boulardii 500 mg twice a day; and group III had quadruple therapy (QТ2) with pantoprazole 20 mg twice a day, clarithromycin 1 g per day, amoxicilina 2 g per day, De Nole 240 mg twice a day and probiotic with Saccharomyces boulardii (Enterol) 500 mg twice a day. The duration of antibacterial therapy was 14 days. The total duration of treatment with proton pump inhibitors at a dose of 20 mg twice a day for 4 weeks. The laboratory efficacy of antimicrobial treatment regimens was confirmed by negative immunochromatography results for H. pylori antigens in the faeces 1 month after the end of treatment. Endoscopic efficacy was determined by the disappearance of endoscopic and histological signs of exacerbation of the disease. Conclusion. The most effective eradicate H. pylori was the scheme QТ2 – 97 %, slightly weaker than QТ1 – 93.7 %. The lowest efficiency was found by the scheme triple therapy – 81.8 %. All three proposed scheme were effective on endoscopic and laboratory parameters, however, the most effective was the scheme QТ2. We associate the reason of high efficiency of the last two schemes with the presence in their composition of probiotic and metronidazole (QТ1) and probiotics with the drug bismuth (QТ2).

Keywords: Helicobacter pylori, triple therapy, quadrotherapy, eradication

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