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The <i>Helicobacter pylori</i>Eradication Rate in a High Prevalence Area (West Africa): Three Triple Therapy Comparative Study

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Open Journal of Gastroenterology 2015年第12期5卷 200-206页

作者： Adjéka Stanislas Doffou Koffi Alain Attia Mamert Fulgence Yao Bathaix Aboubacar Demba Bangoura Ya Henriette Kissy-Anzouan Hartrydt Dimitri Kouamé Kouamé alassan mahassadi Kouamé Justin N’Da Mohamed Kouyaté Constant Assi Aya Thérèse N’dri-Yoman Department of Hepatology and Gastroenterology Centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire Anatomopathology Laboratory of the Centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire Department of Hepatology and Gastroenterology Centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire

In Western countries, the current trend is to use sequential quadruple therapy or bismuth-based instead of triple therapy for the eradication of Helicobacter pylori (H. pylori). In sub-Saharan Africa, high prevalence area of the H. pylori infection, the effectiveness of these triple therapies widely used in routine has been little evaluated. The purpose of this study was to evaluate and compare the effectiveness of three patterns of first-line triple therapy based on combining a proton pump inhibitors (PPI), and 3 types of antibiotics: omeprazole (O), amoxicillin (A), clarythromycin (C) and metronidazole (M). Patients and Methods: This is a randomized clinical trial opened on 3 parallel arms: OAM (group 1 or G1), OAC (group 2 or G2) or OCM (group 3 or G3). The primary endpoint was H. pylori eradication rate after seven days triple therapy. H. pylori diagnosis infection was based on bacterium detection on the histological examination of the gastric biopsies. Histological control was performed 4 weeks after the end of treatment to assess H. pylori eradication rate. Results: The average age of our 153 patients included in the study (86 men) was 44.33 ± 11.72 years. The main reason of the endoscopy was the dyspeptic syndrome (75.16%). The gastroscopy was normal in 28.76%. A Gastric or duodenal peptic ulcer was found in 17% of cases and gastropathy in 45.75%. Histologically, the GC was active in 90.9% of cases, follicular in 35.3% of cases, atrophic in 22.5% of cases and was associated with intestinal metaplasia (IM) in 5.2% of cases. Patients of these three groups (n = 64 for G1, n = 56 for G2 and n = 33 for G3) were comparable for age, gender, endoscopy indications, alcohol consumption history or smoking, and anti-inflammatory drugs taking. Approximately 23% of patients experienced adverse reactions. The overall H. pylori eradication rate was 22.3%. There was no significant difference H. pylori eradication rate depending on the treatment used (28.1%, 21.4% and 15.1% fo

关键词： Helicobacter pylori Triple Therapy Eradication West Africa

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