Comparación de dos esquemas de tratamiento para erradicar helicobacter pylori / Comparison of 2 treatment schemes to erradicate helicobacter pylori

ABSTRACT

Introduction: Anti secretory drugs, antimicrobials and bismuth salts are used with variable success to erradicate helicobacter pylori. Aim: To assess the effectiveness and rates of reinfection of 2 therapeutic modalities H pylori infection in adult patients with duodenal ulcer or non ulcer dyspepsia. Methods: during upper gastrointestinal endoscopy, 5 antral and 2 fundic biopsies were obtained and sent for microbiological and anatomopathological study. Patients infected with Helicobacter pylori were randomly assigned to receive during 2 weeks omeprazole 20 mg od plus amoxicillin 500 mg tid (group A) or bismuth subsalicylate 260 mg bid, metronidazole 250 mg tid and amoxicillin 500 mg tid (group B). A new endoscopy with antral and fundic biopsies was performed to all patients four weeks after discontinuing treatment and six months later to those in whom H pylori was eradicated. Results: 80 patients (40 in each treatment group) completed the treatment and follow up. H pylori was eradicated in 22 patients of group A (55 percent) and 28 of group B (70 percent). Minor adverse effects were reported by 5 patients in group A (12 percent) and 11 in group B (27.5 percent). Six months later, reinfection was documented in 12 patients of group A and 8 of group B (54 percent and 30 percent of those with successful treatment respectively). Ten of 25 patients with duodenal ulcer had reinfections, but there was only one ulcer relapse. Conclusion: These 2 treatment modalities have similar results: