Treatment of Helicobacter pylori-Associated Diseases in Ukraine. The Place of Colloidal Bismuth Subcitrate in the Combination Therapy of These Patients

Abstract

The article considers one of the most topical issues of modern gastroenterology — the treatment of Helicobacter pylori (Hp) infection. It was stressed that eradication therapy is currently determined by Maastricht IV consensus report, and according to the current standards, the first-line therapy should be based on national or regional features of pathogen susceptibility to major antibacterial agents. In case of multiple resistance of Hp, regimens containing fluoroquinolones are used in many countries at the first stage. In countries with a high prevalence of tuberculosis infection, which include Ukraine, to slow the development of mycobacterial resistance, it is necessary to minimize the use of these fluoroquinolones for the treatment of other infections. Therefore, regimens of Hp eradication with the inclusion of fluoroquinolones in our country should be used only after ineffectiveness of the initial treatment at the second stage. Today, bismuth-containing quadruple regimens are used most often. The advantages of using bismuth preparations in antihelicobacter therapy are actively studied and proved in clinical trials. In Ukraine, bismuth-containing regimens with application of colloidal bismuth subcitrate are being used as second-line therapy. This article presents the results of the study on the efficacy of the modified quadruple therapy (proton pump inhibitors combined with furazolidone, amoxicillin and colloidal bismuth subcitrate (De-Nol)) when Hp infection is not eliminated after standard triple therapy. Attention is paid to the differences of treatment regimens taking into account regional features of Hp resistance.

Keywords

• Helicobacter pylori infection
• eradication
• quadruple regimen
• triple regimen
• bismuth preparations