20 bs bùi chí nam evaluation of the effect of pac, ptmb, pla regimen for hp eradication 2016 1

Evaluation of the effect of PAC, PTMB, PLA regimen for Helicobacter pylori eradication Bui Chi Nam, Nguyen Thi Cam Tu, Pham Thi Thu Huong, Nguyen Thanh Cong, Nguyen Xuan Thuy Department of Internal Medicine Gastroenterology – VINMEC Hospital Hà Nội CONTENT 1.Rationale 2.Subjects and research methods 3.Research results 4.Discussion & conclusion RATIONALE - Gastric and duodenal ulcers caused by Helicobacter pylori (HP) is a common disease in the world as well as in Vietnam - HP is the cause of gastric and duodenal ulcers and gastric cancer - Successful HP eradication would benefit from medical treatment and prevention of complications from ulcers and gastrointestinal bleeding, malignization First line regimens of HP eradication - or drugs regimen of proton pump inhibitor (PPI) with two antibiotics (Amoxycillin + clarithromycin (PAC) to 10 days - drugs regimen: combined with Tetracycline PPI + Metronidazole + Bithmus (PTMB) in 14 days The results of the initial regimen Hp eradication depends heavily on the rate of drug resistance in different geographical regions Rate of resistance to Metronidazole, clarithromycin and amoxycillin fluctuated from 38.1%, 85.7%; 38.6% and 18.1% respectively Patients after initial treatment for Hp eradication need a second treatment To assess the therapeutic effect of Hp eradication regimens of PCA, PTMB (First line) and PPI + levofloxacin and Amoxyciline: PLA (Second line) to make strategic choices reasonable regimen for anti-Hp treatment We conducted a study entitled "Evaluation of the effect of treatment of Helicobacter pylori eradication by PAC, PTMB, PLA regimen" Objects and methods of research Time: years from April / 2013-4 / 2016 -  Sample size: 451 eligible patients -  Subjects of study: Patients> = 18 years, meet following criteria: • Inflammatory lesions, gastric duodenal (Endoscopy and or histopathology) • HP bacteria (urease test, or UBT and histopathology) • Post-treatment follow-up in an interval of 6-8 weeks and no antibiotic and PPI use prior 4-week before the re-examination - Objects and methods of research Subjects excluded from the study: Patients taking antibiotics or PPI less than weeks by the time of endoscopy - Patients undergoing active gastrointestinal bleeding - - Cancerous lesions chemical ulcers - No adherence to HP eradication regimen, no follow-up appointments Research Methods: Prospective combined analysis of the data using a retrospective Materials research: Endoscopes Olympus CV 180, HP breath test machine, slicing machine cell, according to a standard process and dyeing read by experienced doctors Research process as follows: Patients> = 18 years of age are diagnosed gastroduodenum ulcers through endoscopy and histopathological diagnosis of HP infection by urease test and histology, patients used regimen for HP eradication by Maastricht Research Methods: Group 1: included 145 patients who had never eradicated HP Apply PPI therapy + Clarithromycine 1gram + Amoxicilline 2gram (PCA) x 10 days The effectiveness of HP eradication by UBT (urea breath test) after 6-8 weeks with the threshold Cut off> 2.5 for positive samples, = = 2.5, the positive samples, and