Avtor/Urednik		Tepeš, Bojan
Naslov		Primerjava dveh trotirnih antimikrobnih shem zdravljenja okužbe z bakterijo Helicobacter pylori
Prevedeni naslov		The comparisson of two antimicrobial triple therapies of Helicobacter pylori infection
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 69, št. 7-8
Leto izdaje		2000
Obseg		str. 505-8
Jezik		slo
Abstrakt		Background. Helicobacter pylori is accepted as the main etiological factor for duodenal and gastric ulcer disease, MALT lymphoma, gastritis and also as class I carcinogen. The majority of European countries and also Slovenia have accepted national guidliness for the therapy of Helicobacter pylori infection. Triple antimicrobial therapies, based on proton pump inhibitors and two antibiotics, are accepted as therapy of choice. The results of those therapies depend on local Helicobacter pylori resistance rate to antibiotics and patients compliance. The aim of study presented was to compare two different triple antimicrobial therapies in every day clinical practice. Methods. Patients who fulfilled the indication for antimicrobial treatment of Helicobacter pylori infection in 1997 and 1998 were randomised in two groups. Patients in group A were treated with OMC (omeprazole 20 mg bid, metronidazole 400 mg bid, clarithromycin 250 mg bid) for 7 days. Patients in group B were treated with OAC (omeprazole 20 mg bid, amoxycillin 1000 mg bid clarithromycin 500 mg bid) for 7 days. Before the enrollment in the study and at least two months after the end of the antimicrobial therapy upper gastrointestinal endoscopy was performed. Two biopsies were taken for rapid urea biopy test and two biopsies were taken for histology. Only Helicobacter pylori positive patients were included in the study and only if all four biopsies were Helicobacter pylori negative at the end of the study, patients were assessed as cured of infection. Results. One hundred and sixty-seven patients were enrolled in group A, and one hundred and twelve patients were cured of infection, the eradication rate is 82.6% (95% confidence interval: 79. 7%-85.5%). In group B eighty-nine patients were enrolled and seventy-three patients were cured of infection, the eradication rate is 82% (95% confidence interval: 78%-86%). (Abstract truncated at 2000 characters)
Izvleček		Izhodišča. Bakterija Helicobacter pylori je danes priznana kot glavni etiološki razlog za ulkusno bolezen želodca, dvanajstnika, limfom MALT, gastritis, hkrati pa je tudi karcinogeni dejavnik I. reda. Kot večina evropskih držav je tudi Slovenija sprejela indikacije za zdravljenje te okužbe. Kot najustreznejšo smo sprejeli enotedensko zdravljenje z blokatorjem protonske črpalke in dvema antibiotikoma. Uspehi posameznih shem zdravljenja so odvisni od rezistence bakterije Helicobacter pylori na antibiotike in sodelovanja bolnikov pri zdravljenju. Namen študije je bil ugotoviti uspešnost dveh različnih antimikrobnih kombinacij v vsakodnevni klinični praksi. Metode. V letih 1997 in 1998 sem bolnike, ki so izpolnjevali merila za zdravljenje, razvrstil v dve skupini. V skupini A so bili bolniki sedem dni zdravljeni s shemo OMC(omeprazol2 X 20 mg, metronidazol2 X 400 mg in klaritromicin 2 X 250 mg). V skupini B pa so bili bolniki sedem dni zdravljeni s shemo OAC(omeprazol2 X 20 mg, amoksicilin 2 x 1000 mg in klaritromicin 2 x 500 mg). Pred začetkom zdravljenja in dva meseca ali več po končanem antimikrobnem zdravljenju so vsi bolniki opravili endoskopijo zgornjih prebavil. Ob tem so imeli odvzeta po dva biopta za hitri ureazni test in po dva biopta za histološko preiskavo. Vsi vključeni holniki so bili pozitivni za Helicobacter pylori. Če so ob kontrolni endoskopiji imeli vse štiri biopte za Helicobacter pylori negativne, so bili ozdravljeni okužbe. Rezultati. V skupino A sem uvrstil 167 bolnikov. Ozdravitev okuže z bakterijo Helicobacter pylori je bila dosežena pri 112, to je 82,6% (95-odstotni interval zaupanja: 79.7-85.5%). (Skrajšano na 2000 znakov)
Deskriptorji		HELICOBACTER INFECTIONS HELICOBACTER PYLORI OMEPRAZOLE AMOXICILLIN CLARITHROMYCIN METRONIDAZOLE TREATMENT OUTCOME