Diagnosis and treatment of Helicobacter pylori in Guyana - abstract

ABSTRACT

This study was designed to assess usefulness of an HP, igG serum blot immunoassay, "Flex-sure test" (F/S) in accurately guiding treatment of HP infection, to compare metronidazole 500mg bd, omeprazole 20 mg bd and clarithromycin 500 mg bd orally (MOC); and amoxicillin 500 mg bd, omeprazole 20 mg bd and clarithromycin 500 mg bd orally (AOC) for 10 days, ineradicating HP 115 of 322 patients with moderate to severe dyspeptic symptoms who were screen with the F/S test were positive and were randomly assigned to 2 treatment regimes. C14 breadth test (B/T) was performed to confirm infection at the start of the treatment, 4 weeks and 6 months after the treatment. 12/115 patient (10.4 percent) were withdrawn from the study after three confirmatory B/T were negative. 6/115 patients (5.2 percent) did not return for treatment. Ninety-seven (97) F/S and B/T positive patients were treated and followed up for 6 months. The most significant symptomatic relief occurred at the first month post-treatment. Bitterness, headache, nausea and diarrhea were the major symptoms experienced. The recurrent rate of HP at 6 months was 2/97 (2 percent). We conclude that F/S assay is a good and fairly accurate screen to commence primary therapy and that MOC and AOC are equally effective in eradicating HP after 10 days of oral theraphy with low recurrence at 6 months. (AU)