A Helicobacter pylori-fertőzés első vonalbeli megszüntetésére alkalmazott hagyományos hármas és egy új, bizmuttartalmú négyes kezelés összehasonlítása

Translated title of the contribution: Comparison of the traditional triple and a new bismuth-containing quadruple therapy in the first-line eradication of Helicobacter pylori

Varga Máté, Drácz Lajos, Kolbenheyer Erik, Varga Ferenc, V. Patai Árpád, N. Solymosi, Patai Árpád

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction and aim: As the efficacy of the first-line traditional treatment used to eradicate Helicobacter pylori (H. p.) decreased below 75% in Hungary, a new protocol had to be created. Method: Supposing the success rate of the traditional therapy (14-day double dose of proton pump inhibitor [PPI], 1000 mg amoxicillin b.i.d., 500 mg clarithromycin b.i.d. [PAC]) to be 75% and the efficacy of the new protocol (10-day 120 mg bismuth dicitrate q.i.d., double dose PPI b.i.d., 500 mg tetracycline q.i.d. and 500 mg tinidazole b.i.d. [BQT]) to be 90%, we calculated 109 patients on each arm. Patients were recruited after upper gastrointestinal endoscopy from 5 endoscopic units in Vas county. The heterogeneity of groups, success rate and side effects of both therapies were evaluated by Fisher exact test; p<0.05 was considered significant. Results: 110 patients were included in the BQT and 109 patients in the PAC group. There was no heterogeneity between the two groups in age, gender and indication of eradication. H. p. eradication was successful in 103/110 (93.6%) in the BQT and 81/109 (74.3%) in the PAC group (p<0.001). The odds ratio in the BQT group for successful eradication was 5.05 (95% confidence interval: 2.02-14.42) as compared to the PAC group (p<0.001). The side effects of the two groups were similar, in the BQT group the frequency was 34.5%. Conclusion: 10 day-long BQT containing double dose PPI with 120 mg bismuth dicitrate q.i.d., 500 mg tetracycline q.i.d. and 500 mg tinidazole b.i.d. is recommended as the first-line treatment for the eradication of H. p. because of its high efficacy and tolerable side effects.

Original languageHungarian
Pages (from-to)1340-1345
Number of pages6
JournalOrvosi hetilap
Volume160
Issue number34
DOIs
Publication statusPublished - Jan 1 2019

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Bismuth
Helicobacter pylori
Proton Pump Inhibitors
Tinidazole
Tetracycline
Gastrointestinal Endoscopy
Clarithromycin
Hungary
Amoxicillin
Therapeutics
Age Groups
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

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A Helicobacter pylori-fertőzés első vonalbeli megszüntetésére alkalmazott hagyományos hármas és egy új, bizmuttartalmú négyes kezelés összehasonlítása. / Máté, Varga; Lajos, Drácz; Erik, Kolbenheyer; Ferenc, Varga; Patai Árpád, V.; Solymosi, N.; Árpád, Patai.

In: Orvosi hetilap, Vol. 160, No. 34, 01.01.2019, p. 1340-1345.

Research output: Contribution to journalArticle

Máté, Varga ; Lajos, Drácz ; Erik, Kolbenheyer ; Ferenc, Varga ; Patai Árpád, V. ; Solymosi, N. ; Árpád, Patai. / A Helicobacter pylori-fertőzés első vonalbeli megszüntetésére alkalmazott hagyományos hármas és egy új, bizmuttartalmú négyes kezelés összehasonlítása. In: Orvosi hetilap. 2019 ; Vol. 160, No. 34. pp. 1340-1345.
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AU - Máté, Varga

AU - Lajos, Drácz

AU - Erik, Kolbenheyer

AU - Ferenc, Varga

AU - Patai Árpád, V.

AU - Solymosi, N.

AU - Árpád, Patai

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N2 - Introduction and aim: As the efficacy of the first-line traditional treatment used to eradicate Helicobacter pylori (H. p.) decreased below 75% in Hungary, a new protocol had to be created. Method: Supposing the success rate of the traditional therapy (14-day double dose of proton pump inhibitor [PPI], 1000 mg amoxicillin b.i.d., 500 mg clarithromycin b.i.d. [PAC]) to be 75% and the efficacy of the new protocol (10-day 120 mg bismuth dicitrate q.i.d., double dose PPI b.i.d., 500 mg tetracycline q.i.d. and 500 mg tinidazole b.i.d. [BQT]) to be 90%, we calculated 109 patients on each arm. Patients were recruited after upper gastrointestinal endoscopy from 5 endoscopic units in Vas county. The heterogeneity of groups, success rate and side effects of both therapies were evaluated by Fisher exact test; p<0.05 was considered significant. Results: 110 patients were included in the BQT and 109 patients in the PAC group. There was no heterogeneity between the two groups in age, gender and indication of eradication. H. p. eradication was successful in 103/110 (93.6%) in the BQT and 81/109 (74.3%) in the PAC group (p<0.001). The odds ratio in the BQT group for successful eradication was 5.05 (95% confidence interval: 2.02-14.42) as compared to the PAC group (p<0.001). The side effects of the two groups were similar, in the BQT group the frequency was 34.5%. Conclusion: 10 day-long BQT containing double dose PPI with 120 mg bismuth dicitrate q.i.d., 500 mg tetracycline q.i.d. and 500 mg tinidazole b.i.d. is recommended as the first-line treatment for the eradication of H. p. because of its high efficacy and tolerable side effects.

AB - Introduction and aim: As the efficacy of the first-line traditional treatment used to eradicate Helicobacter pylori (H. p.) decreased below 75% in Hungary, a new protocol had to be created. Method: Supposing the success rate of the traditional therapy (14-day double dose of proton pump inhibitor [PPI], 1000 mg amoxicillin b.i.d., 500 mg clarithromycin b.i.d. [PAC]) to be 75% and the efficacy of the new protocol (10-day 120 mg bismuth dicitrate q.i.d., double dose PPI b.i.d., 500 mg tetracycline q.i.d. and 500 mg tinidazole b.i.d. [BQT]) to be 90%, we calculated 109 patients on each arm. Patients were recruited after upper gastrointestinal endoscopy from 5 endoscopic units in Vas county. The heterogeneity of groups, success rate and side effects of both therapies were evaluated by Fisher exact test; p<0.05 was considered significant. Results: 110 patients were included in the BQT and 109 patients in the PAC group. There was no heterogeneity between the two groups in age, gender and indication of eradication. H. p. eradication was successful in 103/110 (93.6%) in the BQT and 81/109 (74.3%) in the PAC group (p<0.001). The odds ratio in the BQT group for successful eradication was 5.05 (95% confidence interval: 2.02-14.42) as compared to the PAC group (p<0.001). The side effects of the two groups were similar, in the BQT group the frequency was 34.5%. Conclusion: 10 day-long BQT containing double dose PPI with 120 mg bismuth dicitrate q.i.d., 500 mg tetracycline q.i.d. and 500 mg tinidazole b.i.d. is recommended as the first-line treatment for the eradication of H. p. because of its high efficacy and tolerable side effects.

KW - Antibiotic resistance

KW - Bismuth

KW - Eradication

KW - Helicobacter pylori

KW - Tetracycline

KW - Tinidazole

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