engleski

Is PPI-triple therapy of greater efficacy in peptic ulcer than in non-ulcer dyspeptic patients

Aim: The aim of this study was to examine the possible difference in efficacy of PPI-based triple therapy among Hp+ patients with duodenal/gastric (DU/GU) ulcers ant nonulcer dyspepsia (NUD). Methods: 857 Hp+ consecutive patients with DU (n = 481, 266 M/215 F, mean age 48.6), GU (n = 230, 108 M/122 F, mean age 59.7) and NUD (n = 146, 86 M/60 F, mean age 52.9) treated with 7-days PPI plus amoxycillin and either azithromicyn or metronidazole. Seven biopsies from antrum and corpus for rapid urease test (1), histology (4), and culture (2) were taken during first endoscopy and at least 4 weeks after the end of antibiotics treatment. Hp was considered eradicated when all tests were negative. Results: Baseline characteristics of three groups were not statistically different for sex, age and prescribed therapy. Pre-treatment metronidazole resistance was 33.9 in DU group, 36.3 in GU group, and 43.8 in NUD group; azithromycin resistance was 7.7, 9.8 and 10.0, respectively (NS). Per protocol eradication was achieved in 387/481 (80%, 95% CI: 68-90%) in DU group, 173/230 (75%, 65-84%) in GU group, and 96/146 (65%, 56-77%) in NUD group. Complete clinical improvement was achieved in 72%, 73% and 65%, respectively (NS) Conclusion: The efficacy of eradication therapy as well as clinical improvement was significantly lower in NUD group, especially compared to patients with DU. The mechanism of this difference remains to be explored.

Helicobacter pylori; therapy; peptic ulcer; non-ulcer dyspepsia

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