@Article{Yilmaz2018,
journal="Gastroenterology Review/Przegląd Gastroenterologiczny",
issn="1895-5770",
volume="13",
number="2",
year="2018",
title="Comparison between different first-line therapy protocols in eradicating Helicobacter pylori in a region with high clarithromycin resistance",
abstract=" Introduction :  Helicobacter pylori  infection is encountered in more than 50% of the world population. A high rate of clarithromycin resistance is observed among  Helicobacter pylori  strains in some regions because clarithromycin is a drug commonly used for the treatment of other infections.    Aim : To identify an efficient eradication protocol for patients infected with  H. pylorii  and to suggest an alternative first-line therapy particularly in countries with high clarithromycin resistance.   Material and methods : Patients (18–75 years old) having dyspeptic complaints in a 1-year period and diagnosed with  H. pylorii  infection by gastric biopsy were included and randomised to three groups, each receiving different sequential eradication therapy (LAM-B: lansoprazole, amoxicillin, metronidazole, bismuth: LAM-T: lansoprazole, amoxicillin, metronidazole, tetracycline; LAM-BT: lansoprazole, amoxicillin, metronidazole, bismuth, tetracycline). Eradication was evaluated via urea breath test.    Results : This study included 166 patients (mean age: 40 ±12 years; female, 68.7%) with  H. pylorii  infection. Among them, 50 (30.1%) were in the LAM-B group, 59 (35.5%) were in the LAM-T group, and 57 (34.3%) were in the LAM-BT group. The non-steroidal anti-inflammatory drug use was the lowest in the LAM-BT group. Eradication rates were over 80% and similar in each group, with the highest rate in the LAM-BT group (93%). Adverse event rate was the highest in the LAM-T group.  Helicobacter pylori  eradication was achieved in 143 (86.1%) patients.   Conclusions : The combination regimens without clarithromycin achieved an eradication rate over 80% in all groups. Knowing and monitoring the regional antibiotic resistance rates is important for successful treatment of  H. pylorii  infections.",
author="Yilmaz, Baris
and Koseoglu, Huseyin
and Coskun, Yusuf
and Deveci, Murat
and Kekilli, Murat",
pages="150--156",
doi="10.5114/pg.2018.72732",
url="http://dx.doi.org/10.5114/pg.2018.72732"
}