The comparison of the effect of quinolon based teratment and triple treatment ( Claritromicin, Amoxisilin, PPI) on heli̇cobacter pylori eradi̇cation

Helicobacter pylori infection is the main cause of chronic gastritis and peptic ulcer disease, and is closely related to the development of gastric carcinoma and MALT lymphoma. Consequently, great emphasis has been placed on its successful Hp eradication. However, the eradication rates of Hp infection have been shown to decrease in the recent studies. So new treatment regimens are needed.The aim of this study was to compare the efficacies of Hp eradication rates of standard therapy protocol, 14 day quinolon based and quinolon based sequential therapy .102 Hp positive dyspeptic patients was admitted to Karadeniz Technical University Farabi Hospital Gastroenterology Department between October 2009 - August 2010 were included the study. Hp diagnosis was made by rapıd urease test and histopathological examination. Patients who were diagnosed positively were divided into 3 groups according to their treatment protocols. Each group consists of 34 patients.First group with standard therapy received clarithromycin 2x500mg, amoxicillin 2x1g, lansoprasol 2x30 mg for 2 weeks. Secong group received for 2week, moxifloxacin 1x400 mg, amoxicillin 2x1g and lansoprasol 2x30 mg. Third group received kinolon based sequential therapy; first week amoxicillin 2x1g, lansoprasol 2x30 mg and second week moxifloxacin 1x400 mg, lansoprasol 2x30 mg. After this period, patients received lansoprasol 1x30mg for 4 weeks. Hp eradication was controlled by UNT , after two weeks of the treatment. The response of the Hp eradication therapy was interpreted by Ki-square test and p<0,05 was considered meaningful.In our study, patient's average age were 40,2 ± 13,2 . There was no significant statistically difference ın terms of the gender and mean age between all groups. There was no significant statistically difference between gender and the result of the therapy (p=0.45). There was no signifcant statistical difference in terms of endoscopic and histopathological diagnosis in all groups. Hp eradication rate was 64,2 % (22/34) in standard therapy group, 67,6 % (23/24) in 14 day therapy group, 64,2 % (22/34) in quinolon based sequential therapy group. There was no statistically significant difference ın terms of Hp eradication rates between three group (p=0,95).Our eradication rate was below 80% and this result is not acceptable eradication rate. This low eradication rate may be related with high resistance rate of Hp to clarithromycin and moxifloxacin, and noncompliance of patients with those regimens. Hp antibiotic resistance profile may be differ according to the geographic regions. So further multıcenter, randomized studies investigating moxifloxacin resistance factor are needed. Furthermore new studies about different Hp eradication regimens are needed for succesfull Hp eradication treatment.