Experience of using different schemes of eradication therapy for Helicobacter pylori infection and their effectiveness in Ukraine

Abstract

Background. The resistance of Helicobacter pylori (H.pylori) to antibacterial drugs has increased in recent years. This is primarily due to the unwarranted use of antibiotics, as demonstra­ted by the recent COVID-19 pandemic. The choice of the optimal regimen and duration of treatment are current issues today. The aim: retrospective study on the effectiveness of 14-day H.pylori eradication regimens used in 2022–2023 and comparison of their effectiveness and safety with those of 10-day regimens used in 2020–2021 in Ukraine. Materials and methods. The data of 242 patients (123 men and 119 women) aged 18 to 65 years with chronic gastritis, peptic ulcer of the duodenum and stomach associated with H.pylori were analyzed retrospectively. All patients were treated with standard regimens according to the Maastricht V and VI Consensus. H.pylori infection was confirmed by a rapid urease test, determination of fecal antigen and histologically. Results. As a result of the study, it was found that 10-day regimens with triple therapy had an efficiency of 80–81 %. The effectiveness of a 14-day triple therapy with esomeprazole and lansoprazole was significantly higher compared to a 10-day regimen, 85 and 86 %, respectively (p < 0.05). Howe­ver, the frequency of side effects was higher with a 14-day therapy. A 10-day triple regimen with levofloxacin compared to a standard 10-day triple therapy had the lowest efficacy of 78 %. But when levofloxacin therapy was increased to 14 days, its effectiveness became comparable to that of a 14-day triple therapy, 85 %. The highest efficiency was demonstrated by a 10-day and 14-day therapy with furazolidone, which was added to amoxicillin and levofloxacin: 95 and 97.8%, respectively. Conclusions. The effectiveness of schemes with clarithromycin in Ukraine remains high. Taking drugs for 14 days increases the percentage of H.pylori eradication and the frequency of unwanted effects. Addition of furazolidone to levofloxacin and amo­xicillin increases the rate of successful H.pylori eradication.