engleski

Endoscopy and histology of gastric mucosa and antibiotics sensitivity - do they influence the outcome of H. pylori eradication therapy

Aim: The study aimed to examine the possible influence of endoscopical and histological findings and antibiotics sensitivity on the success rate of H. pylori eradication therapy. Methods: 578 consecutive patients (F/M 258/320) with H. pylori infection were undergone to therapy. After the first trial with one of ordinary therapeutic protocols two groups were formed: 1. group - 126 patients (F/M 61/65) with noneradicated infection, 2. group - 452 patients with eradicated infection (F/M 197/255). Endoscopic diagnosis (gastric ulcer, duodenal ulcer and ulcer scar , non-ulcer dyspepsia), histological characteristics of gastric mucosa according to Sydney classification (2 biopsy specimens of body and 2 of antral mucosa) and primary resistancy to amoxicillin, azithromycin, metronidasole, clarithromycin (MIC Agar dilution) were analysed. Results: Endoscopy: Noneradicated (%) Eradicated (%) Gastric ulcer/scar 39 (31) 150 (33) N.S. Duodenal ulcer/scar 86 (68) 291 (64) N.S. Nonulcer dyspepsia 18 (14) 53 (12) N.S. Primary resistancy: Amoxicillin 0 0 Metronidazole 30% 30% N.S. Clarithromycin 21% 6% p<0.05 Azithromycin 16% 3% p<0.05 There was no differences between the groups concerning the all histological parameters (inflammation, activity, atrophy, intestinal metaplasia, H. pylori colonisation rate). Conclusion: Neither endoscopical nor histologic characteristics but only primary sensitivity to antibiotics influence the outcome of H. pylori eradication therapy.

Helicobacter pylori; endoscopy; histology; antibiotics sensitivity; therapy

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