Sher -E - Bangla Medical College, Bangladesh
Title: Comparison of results of rapid urease test (RUT) and PCR after Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer disease patients at a medical university hospital
Biography: Anisur Rahman
In this study 63 H. pylori positive patients with peptic ulcer disease were randomized for eradication therapy for two weeks. Four regimens were used : ECA consisting of Esemoprazole (20 mg bid), Clarithromycin (500mg bid) and Amoxicillin (1 gm bid), EALconsisting of Esemoprazole (20 mg bid), Amoxicillin (1gm bid), Levofloxaxin (500 mg once daily), EAT consisting of Esemoprazole (20 mg bid), Amoxicillin (1gm bid), Tetracycline (500 mg bid) and ETL consisting of Esemoprazole (20 mg bid), Tetracycline (500 mg bid) and Levofloxaxin (500 mg once daily). Out of 63 patients 13 dropped out. Six weeks after completion of therapy upper GI endoscopy was repeated to see endoscopic improvement and RUT and PCR for H. pylori was carried out. Conclusive result was obtained in 40 cases in RUT and PCR could be done in 37 cases. PCR positivity was considered when Vac A s1m1 or s1m2 or m2s1 were found to be positive. Eradication therapy showed no statistically significant difference in different regimens (p> 0.05). Thirty six patients were found to be RUT negative and 4 were found to be RUT positive. While RUT after eradication therapy showed 90% eradication rate PCR showed only 40.5% eradication rate. If PCR negativity is considered as successful eradication, this result is alarming. PCR positivity with negative RUT after eradication therapy in our patients may be explained by possible high percentage of the dead or coccoid form of H. pylori after antibiotic treatment.