Eficiencia de la Terapia Triple y Dual con Vonoprazan para la infección por Helicobacter pylori
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Resumen
La gastritis por Helicobacter pylori (H. pylori) se clasifica como enfermedad infecciosa y su tratamiento óptimo debe superar el 90-95% de erradicación del H. pylori. La Terapia Triple tradicional (IBP + Amoxicilina + Claritromicina) ha sido su tratamiento de elección, pero el mismo ha caído a un 80% de éxito, debido a la alta resistencia global a la Claritromicina, en Venezuela la resistencia a la Claritromicina oscila entre el 7% y 55.5%. Además de los antibióticos, el H. pylori requiere para su replicación activa un pH intragástrico > 5.0. A pH bajo (~3.3), el H. pylori sobrevive en estado no replicativo, evadiendo la acción antimicrobiana. Los bloqueadores de ácido competitivos de potasio (PCABs), como el Vonoprazan, elevan y mantienen el pH gástrico de forma más rápida y potente que los IBP tradicionales, esto induce el estado replicativo de la bacteria, optimizando el efecto antimicrobiano. Objetivo: Evaluar la eficiencia de dos esquemas con Vonoprazan en Venezuela: Terapia Triple (con Amoxicilina y Claritromicina) y Terapia Dual (solo con Amoxicilina). Resultados: 80 pacientes en total. Terapia Triple (n=40): 95.0% de eficiencia terapéutica (38/40 pacientes erradicados; Odds de 19:1). Terapia Dual (n=40): 90.0% de eficiencia terapéutica (36/40 pacientes erradicados; Odds de 9:1). Los efectos adversos reportados en la literatura son leves (diarrea, estreñimiento, náuseas) y resuelven de forma espontánea. Conclusión: Ambos esquemas alcanzan o superan el umbral clínico del 90%, demostrando una alta eficiencia terapéutica individual para la erradicación del H. pylori en la población estudiada.
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DOI: http://dx.doi.org/10.61155/gen.v80i3.830
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