DEPENDENCE OF THE EFFICIENCY OF THE 1-ST LINE ERADICATION THERAPY ON THE STATE OF THE MUCOUS MICROFLORA OF THE COLON IN PATIENTS WITH HELICOBACTER PYLORI-ASSOCIATED CHRONIC GASTRITIS

Abstract

The article presents the results of a study conducted to determine the possible dependence of the efficacy of amoxicillin-clarithromycin-containing triple scheme of first-line eradication therapy on the initial state of the mucous microflora of the colon in patients with Helicobacter pylori (HP)-associated chronic gastritis. The study was carried out on 50 patients (27 men and 23 women, age from 24 to 72 years, on average 46.2±3.7 years). Verification of the above diagnosis was carried out by fibrogastroduodenoscopy (FGDS) with biopsy of the mucous membrane of the antrum of the stomach and subsequent histological examination and rapid urease test to detect HP. Assessment of the state of the parietal microflora of the large intestine was carried out by means of bacteriological examination of two biopsies of the mucous membrane of the sigmoid colon and cecum. All patients received a triple regimen as first-line therapy, including rabeprazole 20 mg + amoxicillin 1 g + clarithromycin 500 mg 2 times a day for 14 days. The control of the eradication efficiency was carried out in the course of repeated FGDS and rapid urease test, performed not earlier than 4 weeks after the end of the course of treatment. The indicator of the effectiveness of first-line eradication therapy in patients with colonic dysbiosis progressively decreased with the transition to a higher severity of the latter. Thus, it had a maximum value of 86,6% in the group of patients with first degree dysbiosis. In patients with the second and third degree of severity of dysbiosis, the prescribed therapy was effective in 73,6 and 50% of cases, respectively, and among patients with the fourth degree of severity of dysbiosis, there were no cases of successful eradication at all. Significantly higher values ​​of the content of bifidobacteria, lactobacilli and typical strains of E. coli among patients with successful eradication was demonstrated.