The Comparison of the efficiency of one and two weeks LAC (lansoprazole, amoxycillin, clarithromicin) treatment protocols in the eradication of helicobacter pylori by using breath test

THE COMPARISON OF THE EFFICIENCY OF ONE AND TWO WEEKS LANSOPRAZOLE, AMOXYCILLIN, CLARITHROMYCIN (LAC) TREATMENT PROTOCOLS IN THE ERADICATION OF HELICOBACTER PYLORI BY USING UREA BREATH TEST It has been known that, Helicobacter pylori (Hp) is highly associated with duodenal ulcer disease, having been isolated from up to 95 % of patients with duodenal ulcer. Cure of Hp infection has resulted dramatically in ulcer healing and a significant reduction in ulcer recurrence and complications. In other words, treatment of peptic ulcer means Hp eradication. There is an agreement on the triple therapy (PPI and two of the following: clarithromycin, a nitroimidazole and amoxycillin) for eradication of Hp but a continuous debate about the duration of therapy in Turkey as all over the World. In this study we aimed to compare the efficacy of one week of treatment with lansoprazole, amoxycillin, clarithromycin (LAC) versus two weeks of the same treatment by 13C-urea breath test. Fifty-one patients (28 male, 23 female, mean age = 44.8 ± 13.1) were enrolled in the study based on histological detection of Hp in gastric biopsy specimens and positive rapid urease test results. They were randomized to receive 30 mg. lansoprazole, 1 gr. amoxycillin and 500 mg. clarithromycin twice daily for 7 (Group 1) or 14 days (Group 2). Eradication of Hp was determined by 13C-urea breath test at least 6 weeks after completion of therapy. Based on intention-to-treat (ITT) and per-protocol (PP) analysis, Hp eradication rates of Group 1 and Group 2 were (19/25) 76 %, (19/25) 76 % and (21/26) 81 %, (20/24) 83 %, respectively (p > O.Oj). And there were no significant differences in eradication rates between two groups. In conclusion, one week treatment with LAC is as effective as two week's treatment. Besides it is well-tolerated and associated with high patient compliance. For eradication of Hp one week LAC therapy is sufficient. Also, we believe that we can obtain more trustable results in accordance with world standarts by using urea breath test for determination of Hp eradication in Turkey. *1