Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

TY - JOUR

T1 - Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

AU - Roug, Stine

AU - Madsen, Lone Galmstrup

PY - 2012/12

Y1 - 2012/12

N2 - INTRODUCTION: To optimize the care for Helicobacter pylori- associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradication therapy were considered. MATERIAL AND METHODS: Patients who tested positive for H. pylori infection using a rapid urease test (RUT) during a three-year period were evaluated retrospectively according to demographics, eradication rate, type of eradication therapy, endoscopic findings and number of former attempts of eradication therapy. RUT-positive patients without a posttreatment evaluation were invited for a urea breath test. RESULTS: The overall H. pylori infection rate was 15% (117/796). Only 48/105 (46%) patients had a post-treatment examination to test the effect of H. pylori eradication therapy. The eradication rate by first-line therapy was 75% (58/77). The second-line eradication rate was 87%. 94% (72/77) had the recommended standard triple therapy for first-line eradication therapy. The number of former eradication attempts was the only clinical characteristic that significantly predicted failure of eradication therapy. Among patients with H. pylori-positive peptic ulcer, 21/28 (75%) achieved successful eradication after first-line treatment. CONCLUSION: Organised follow-up regimes are recommended, especially in patients with absolute treatment indications with a view to optimizing the care for patients infected with H. pylori.

AB - INTRODUCTION: To optimize the care for Helicobacter pylori- associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradication therapy were considered. MATERIAL AND METHODS: Patients who tested positive for H. pylori infection using a rapid urease test (RUT) during a three-year period were evaluated retrospectively according to demographics, eradication rate, type of eradication therapy, endoscopic findings and number of former attempts of eradication therapy. RUT-positive patients without a posttreatment evaluation were invited for a urea breath test. RESULTS: The overall H. pylori infection rate was 15% (117/796). Only 48/105 (46%) patients had a post-treatment examination to test the effect of H. pylori eradication therapy. The eradication rate by first-line therapy was 75% (58/77). The second-line eradication rate was 87%. 94% (72/77) had the recommended standard triple therapy for first-line eradication therapy. The number of former eradication attempts was the only clinical characteristic that significantly predicted failure of eradication therapy. Among patients with H. pylori-positive peptic ulcer, 21/28 (75%) achieved successful eradication after first-line treatment. CONCLUSION: Organised follow-up regimes are recommended, especially in patients with absolute treatment indications with a view to optimizing the care for patients infected with H. pylori.

KW - Adult

KW - Aged

KW - Anti-Bacterial Agents

KW - Breath Tests

KW - Cohort Studies

KW - Drug Therapy, Combination

KW - Female

KW - Follow-Up Studies

KW - Gastroscopy

KW - Helicobacter Infections

KW - Helicobacter pylori

KW - Humans

KW - Male

KW - Middle Aged

KW - Monitoring, Physiologic

KW - Peptic Ulcer

KW - Retrospective Studies

KW - Risk Assessment

KW - Severity of Illness Index

KW - Time Factors

KW - Treatment Outcome

KW - Urease

M3 - Journal article

C2 - 23290289

SN - 2245-1919

VL - 59

SP - A4553

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 12

ER -