Comparison of second line treatment regi̇mens and hybrid treatment regi̇men on heli̇cobacter pylori̇ eradi̇cati̇on

Introduction and aim: Helicobacter pylori (H.pylori) prevalence is high in our country and about % 80. Although there are many avaliable H.Pylori eradication treatment protocols, there is no common, ideal treatment for all society. Increasing resistance to clarithromycin in our country is known to reduce the effect of the classical treatment protocol (triple therapy) success of H.Pylori eradication. In this study, second-line treatments for H. pylori eradication therapy was aimed to compare the hybrid. Material and method: Patients who presented with complaints of indigestion to Ankara Gulhane Military Medical Academy and Abant Izzet Baysal University the School of Medicine gastroenterology clinics, before the first-line treatment history and endoscopic biopsy or urea-breath test shown that persisted of H. pylori infection with patients enrolled in the study. Patients were randomly assigned in order of application. Bismuth 300 mg 2x2, metronidazole 500 mg 3x1, amoxycillin 1000 mg 2x1 and pantoprozol 40 mg 2x1 for 14 days was given to the first group; Amoxycillin 1000 mg 2x1, tetracycline 500 mg 4x1, Bismuth 300 mg 2x2 and pantoprozol 40 mg 2x1 for 14 days was given to the second group; Amoxycillin 1000 mg 2x1, Bismuth 300 mg 2x2, pantoprozol 40 mg 2x1 in the first week and Amoxycillin 1000 mg 2x1, Bismuth 300 mg 2x2, pantoprozol 40 mg 2x1, tetracycline 500 mg 4x1, metronidazole 500 mg 3x1 in the second week was given to the third group. The results were evaluated with urea-breath test after 2 weeks of treatment cessation. Results: Per protocol eradication rates for each group are; % 57.1 for first group, % 82.4 for second group and % 69.4 for third group. Intent-to-treat eradication rates are; % 51.9 for first group, % 82,4 for second group, % 56,5 for third group. Eradication rates of second group treatment protocol are statistically significant than the other protocols. Conclusion: Metronidazole free bismuth quadruple eradication therapy better than other treatment groups as second-line treatment regimens and were found to be statistically significant. In the other treatment regimens did not achieve the desired and expected success. This is needed on the issue that a large number of patients participating in the comprehensive study. viii Keywords: Helicobacter Pylori (H.pylori), treatment protocol