Otsenka effektivnosti standartnoy troynoy terapii infektsii Helicobacter pylori u detey i podrostkov iz raznykh regionov Rossii


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The effectiveness of standard 1-line eradication schemes recommended by Russian and international consensuses for the treatment of Helicobacter pylori (HP) infection, including the proton pump inhibitor, amoxicillin and clarithromycin or metronidazole, has declined substantially over the last decade. This is due to the growing antibiotic resistance of HP, primarily - to clarithromycin, with possible regional features. We conducted a comparative evaluation of the frequency of occurrence SagA (+) strains of HP, and mutations that determine its resistance to clarithromycin, and evaluation of effectiveness of standard first-line therapy, that included omeprazole, amoxicillin and clarithromycin (OAC) in age-related doses in 153 children and adolescents in St. Petersburg and in 104 in North Ossetia. CagA (+) strains were detected in 52 % of children and adolescents from St. Petersburg and in 35 % - from Vladikavkaz. Mutations which cause HP resistance to clarithromycin were identified in 39 % of St. Petersburg residents, and only in 12,2 % of residents of North Ossetia. HP eradication was achieved in 17 of 23 (74 %) patients from North Ossetia and in 8 of 15 (53 %) patients from St. Petersburg. The results showed significant differences in toxigenicity of HP strains and in their resistance to clarithromycin in different regions of Russia, which accounts for the differences in the effectiveness of standard therapy for HP infection.

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