First-line therapy in Helicobacter pylori eradication therapy: experience of a surgical clinic.
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).


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 2×1, 1000 mg AMO 2×1, and 500 mg CLA 2×1 for 14 days, whereas the BPMT group was designed from patients who received 600 mg BS 2×1, 40 mg omeprazole (O) 2×1 or 30 mg L 2×1, 500 mg MET 3×1 and 500 mg TET 4×1.


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).


CONCLUSIONS
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.
Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
Gökhan Selçuk
GS
Özbalcı
Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
Saim Savaş
SS
Yürüker
Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
İsmail Alper
İA
Tarım
Clinic of General Surgery, Kurtalan State Hospital, Siirt, Turkey.
Hamza
H
Çınar
Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
Ayfer Kamalı
AK
Polat
Clinic of Radiology, Mehmet Aydın Training and Research Hospital, Samsun, Turkey.
Aysu Başak
AB
Özbalcı
Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
Kağan
K
Karabulut
Department of General Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
Kenan
K
Erzurumlu
Helicobacter pylori; eradication; quadruple therapy; triple therapy