RESUMO
BACKGROUND: First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens. MATERIALS AND METHODS: Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed. RESULTS: Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days - in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), 13C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported. CONCLUSION: Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , Adulto , Humanos , Furazolidona/efeitos adversos , Estudos Prospectivos , Quimioterapia Combinada , Antibacterianos/efeitos adversos , Amoxicilina/efeitos adversos , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/diagnóstico , Inibidores da Bomba de Prótons/efeitos adversos , Resultado do Tratamento , Federação Russa/epidemiologia , Sistema de RegistrosAssuntos
Antibacterianos/administração & dosagem , Claritromicina/administração & dosagem , Farmacorresistência Bacteriana , Infecções por Helicobacter , Helicobacter pylori , Úlcera Gástrica , Feminino , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Federação Russa/epidemiologia , Úlcera Gástrica/tratamento farmacológico , Úlcera Gástrica/epidemiologia , Úlcera Gástrica/microbiologia , População UrbanaAssuntos
Benzimidazóis/economia , Benzimidazóis/uso terapêutico , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/economia , Inibidores da Bomba de Prótons , Bombas de Próton/economia , 2-Piridinilmetilsulfinilbenzimidazóis , Administração Oral , Adulto , Idoso , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Rabeprazol , Resultado do TratamentoAssuntos
Pancreatite/tratamento farmacológico , 2-Piridinilmetilsulfinilbenzimidazóis , Adulto , Benzimidazóis/uso terapêutico , Doença Crônica , Método Duplo-Cego , Quimioterapia Combinada , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/uso terapêutico , Projetos Piloto , ATPases Translocadoras de Prótons/antagonistas & inibidores , Rabeprazol , Federação RussaRESUMO
The criteria of choice of proton pump inhibitor at acid-dependent diseases such as gastroesophageal reflux, peptic ulcer, diseases associated with Helicobacter pylory are discussed in the article. The presented data of meta-analysis of efficiency (clinical-and-endoscopic, economical), safety and tolerance, cost and simplicity of use show that today rabeprasol (pariet) is the drug of choice.
Assuntos
Antiulcerosos/uso terapêutico , Refluxo Gastroesofágico/tratamento farmacológico , Inibidores da Bomba de Prótons , Antiulcerosos/farmacologia , HumanosAssuntos
Úlcera Duodenal/tratamento farmacológico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , 2-Piridinilmetilsulfinilbenzimidazóis , Adolescente , Adulto , Amoxicilina/administração & dosagem , Amoxicilina/uso terapêutico , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Antiulcerosos/administração & dosagem , Antiulcerosos/uso terapêutico , Benzimidazóis/administração & dosagem , Benzimidazóis/uso terapêutico , Claritromicina/administração & dosagem , Claritromicina/uso terapêutico , Quimioterapia Combinada , Úlcera Duodenal/microbiologia , Inibidores Enzimáticos/efeitos adversos , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/administração & dosagem , Omeprazol/análogos & derivados , Omeprazol/uso terapêutico , Penicilinas/administração & dosagem , Penicilinas/uso terapêutico , ATPases Translocadoras de Prótons/antagonistas & inibidores , RabeprazolRESUMO
AIM: Choice of optimal antihelicobacter (AH) treatment of ulcer. MATERIALS AND METHODS: 249 outpatients with duodenal ulcer associated with Helicobacter pylori entered a blind multicenter controlled trial. The patients were given one of the following drugs: metronidazole, tonidazol, amoxicilline, clarithromycin, rovamycin, omeprazole, azitromycin. RESULTS: Of all the drugs used, rovamycin appeared preferable as it has high AH activity, is safe and cost-effective. CONCLUSION: Rovamycin has a high AH activity and can be applied for treatment of diseases associated with Helicobacter pylori as a drug of choice.