) UBT-C41( بررسي مقايسه اي تاثير رژيم هاي درماني ضد هليكوباكتر پيلوري معمول در كلينيك با استفاده از تست تنفسي اوره نشاندار

Comparative Evaluation of Effectiveness of Prescribed Anti H. Pylori Regimens Using C14 Urea Breath Test

Multiple therapeutic combinations have been tested to determine the ideal regimens for eradication of Helicobacter Pylori as the major factor in peptic ulcer diseases with different results depending on geographic area. Our aim was to evaluate the effectiveness of currently prescribed anti H. Pylori regimens in Tehran-Iran. We enrolled 415 subjects (242 males, 173 females, age 11-82 years) with documented H. Pylori infection of the stomach from outpatients of the gastroentrology department of Shariati Hospital. In all patients H. Pylori infection was identified by rapid urease test and or histology. Patients were then treated by different H. Pylori regimens (Triple or quadriple) on an intention to treat basis. One to six months after completion of therapy C14 urea breath test (C14-UBT) was performed for assessment of eradication. Overall success rate of all regimens were 37%, patient compliance (usage oft 80% drugs) were satisfactory (94%) and was identical for all regimens. The results of this intention-to -treat study was comparable with controlled (perprotocol) studies. The regimen containing amoxicillin + furazolidone was more successful than that of amoxicillin + metronidazole (83.3% vs 66.2%, P<0.05). Only the regimen containg amoxicillin + aetronidazole + omeprazole was superior to H2 receptor antagonists (86.6% Vs 66.2%, P < 0.05). The most successful antibiotic combination was tetracycline + furazolidone (100% success rate) which warrants more evaluation in a separate study. Successful eradication rate was identical in groups 1 and 2 evaluated 1-3 months and 3-6 months after completion of therapy respectively (73.6% vs 71.1%, P>0.05). Conventialy there was no significant difference between intention-to-treat therapy with reported preprotocol eradication rate. The best drug regimen in this study was bismuth + tetracycline + furazolidone + acid secretory inhibitors. Replacement of metronidazak by furazolidone was effective in improving eradication rate. In assessment of success oieradication, results of 3 months versus 6 months after therapy were almost similar and comparable.