Efektivitas Pemberian Antibiotik Disertai Lansoprazol pada Refluks Laringofaring dengan Infeksi Helicobacter pylori

Abstract

Refluks laringofaring adalah aliran balik isi lambung ke daerah laringofaring dan dapat dipengaruhi oleh infeksi Helicobacter pylori. Regimen terapi untuk infeksi H. pylori terdiri atas proton pump inhibitor (PPI) dan dua jenis antibiotik yaitu amoksisilin dan klaritromisin. Peran PPI pada regimen ini masih diteliti. Dilakukan penelitian mengenai perbandingan efektivitas terapi antibiotik disertai PPI (lansoprazol) terhadap perbaikan gejala klinis dan kualitas hidup penderita refluks laringofaring dengan infeksi H. pylori. Penelitian ini dilakukan di Departemen THT-KL RS Dr. Hasan Sadikin Bandung periode September 2009-Desember 2010 merupakan randomized clinical trial dengan pengamatan open label.Data dianalisis dengan menggunakan uji t dan uji Mann Whitney. Penelitian ini melibatkan 26 subjek penelitian yang dibagi menjadi dua kelompok. Kelompok pertama diberikan regimen terapi H. pylori, berupa klaritromisin dan amoksisilin dengan lansoprazol dan kelompok kedua diberikan klaritromisin dan amoksisilin tanpa lansoprazol. Dilakukan pemeriksaan skor gejala refluks (SGR), skor temuan refluks (STR), dan penilaian kualitas hidup dengan kuesioner reflux qual short-form (RQS). Evaluasi dilakukan setelah 2 minggu. Didapatkan perbedaan bermakna (p=0,034) skor SGR pascaterapi pada kelompok perlakuan antibiotik kombinasi dengan lansoprazol. Tidak didapatkan perbedaan bermakna (p=0,169) pada perbaikan STR pascaterapi. Perbaikan skor RQS lebih baik pada kelompok perlakuan pertama dibandingkan dengan kelompok kedua (p=0,018). Disimpulkan bahwa pemberian campuran antibiotik kombinasi dan lansoprazol lebih efektif terhadap perbaikan gejala klinis dan kualitas hidup dibandingkan dengan tanpa lansoprazol. [MKB. 2012;44(4):224–32].

Kata kunci: Helicobacter pylori, kualitas hidup, lansoprazol, refluks laringofaring

The Effectiveness of Antibiotics with Lansoprazole in the Treatment of Laryngopharyngeal Reflux with Helicobacter pylori Infection

Abstract

Laryngopharyngeal Reflux (LPR) is a reflux of gastric content to the laryngopharyngeal and influenced by Helicobacter pylori infection. The treatment of H. pylori infection consists of proton pump inhibitor and two kinds of antibiotics, i.e. amoxicillin and clarithromycin. The role of PPI is currently being studied. The objectives of the research were to compare the effectiveness of antibiotics regimen with and without lansoprazole in reducing the level of the severity and quality of life improvement in LPR patients with H. pylori infection. Twenty six subjects were divided into two groups; the first group received antibiotics with lansoprazole and the second group received antibiotics without lansoprazole. The research subjects were assessed using reflux symptom index (RSI) questionnaire and reflux finding score (RFS) while the assessment on the quality of life was performed using reflux qual short-form (RQS) questionnaire. These data were obtained at baseline and after 2 weeks of treatment. The method was randomized clinical trial with open label observation and the analysis was conducted using t and Mann Whitney tests. There was a significant improvement in the RSI post treatment in the first group (p=0.034). The difference in RFS was not significantly different statistically between both groups (p=0.169). The RQS was significantly better statistically in the first group (p=0.018). It is concluded that treatment regimen with claritromicin, amoxycillin and lansoprazole is more effective in the treatment of LPR associated with H. pylori infection compared to without lansoprazole. [MKB. 2012;44(4):224–32].

Key words: Helicobacter pylori, laryngopharyngeal reflux, lansoprazole, quality of life

DOI: http://dx.doi.org/10.15395/mkb.v44n4.215