The ways of antihelicobacter therapy in Ukraine (based on the data of analysis of the Ukrainian Registry Hp-EuReg — UKRAINE)
Journal Title: Сучасна гастроентерологія - Year 2018, Vol 0, Issue 5
Abstract
Objective — to assess the state of affairs in the diagnosis and treatment of Helicobacter pylori infection in Ukraine and their conformity with the modern international recommendations. Materials and methods. The performed analysis included data of 500 patients with H. pylori-associated gastrointestinal diseases, registered in the period of the year 2013 to 26.10.2018 in the Ukrainian Registry «gfadeenko» within the frameworks of the multicentre prospective trial Hp-EuReg — UKRAINE, initiated by the European Group on the investigation H. pylori infection and microbiota (EHMSG). All patients were administered antihelicobacter therapy (AHBT). Results. The predominated nosological units, for which AHBT was prescribed, were chronic gastritis (73.7 %) and duodenal ulcer 23.3 %. The mostly prevailed methods of primary H. pylori diagnosis were histological (50.8 %), serologic (26.7 %) and fast urease test (19.5 %). The AHBT duration was 7 days in 15.4 % of cases, 10 days in 37.6 %, and 14 days in 47.0 % of cases. The proton pump inhibitor pantoprazole was administered in the AHBT schemes most frequently (80.5 %). For the eradication control, stool test with H. pylori antigen identification in feces was actively used (90.5 %), and not actively the histological method (5.7 %) and urease breast test (1.9 %). Serological test was used in 2.9 % cases, and this was a significant diagnostic error. The eradication efficacy at the administration of the standard triple therapy was 53.5 % at 7-days course, 68.2 %, at 10-days course and 75.0 % at 14-days treatment. The use of triple therapy with addition of bismuth tripotassium dicitrate (VTD), the eradication level at 7-days course reached 71.4 %, at 10-days 92.6 %, and at 14-days 94.1 %. Conclusions. The non-compliance of the Maastricht-V recommendations regarding the duration of AHBT and eradication control has been revealed. Pantoprazole was administered in the AHBT schemes most frequently, that was stipulated by the comorbidity presence in the most of patients and risk of the inter-medication interactions. The insufficient efficacy of 7-days triple therapy has been established, as well as sub-optimal efficacy of 10- and 14-days schemes of triple AHBT and 7-days of triple AHBT with VTD addition. The VTD addition in 10- and 14-days schemes of triple therapy promoted the increase of eradication efficacy (more than 90 %), thus making this method of AHBT optimization actual for Ukraine.
Authors and Affiliations
G. D. Fadieienko, Ya. V. Nikiforova, N. I. Cherelyuk
Keywords
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- EP ID EP418304
- DOI 10.30978/MG-2018-5-37
- Views 129
- Downloads 0
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