Efficacy of serology driven “test and treat strategy” for eradication ofH. pyloriin patients with rheumatic disease in the Netherlands
✍ Scribed by H. T. J. I. de Leest; K. S. S. Steen; W. F. Lems; M. A. F. J. van de Laar; A. M. Huisman; S. W. Kadir; H. H. M. L. Houben; P. J. Kostense; E. J. Kuipers; B. A. C. Dijkmans; Y. J. Debets-Ossenkopp
- Publisher
- Springer
- Year
- 2011
- Tongue
- English
- Weight
- 123 KB
- Volume
- 30
- Category
- Article
- ISSN
- 0934-9723
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✦ Synopsis
The treatment of choice of H. pylori infections is a 7-day triple-therapy with a proton pump inhibitor (PPI) plus amoxicillin and either clarithromycin or metronidazole, depending on local antibiotic resistance rates. The data on efficacy of eradication therapy in a group of rheumatology patients on long-term NSAID therapy are reported here. This study was part of a nationwide, multicenter RCT that took place in 2000–2002 in the Netherlands. Patients who tested positive for H. pylori IgG antibodies were included and randomly assigned to either eradication PPI-triple therapy or placebo. After completion, follow-up at 3 months was done by endoscopy and biopsies were sent for culture and histology. In the eradication group 13% (20/152, 95% CI 9–20%) and in the placebo group 79% (123/155, 95% CI 72–85%) of the patients were H. pylori positive by histology or culture. H. pylori was successfully eradicated in 91% of the patients who were fully compliant to therapy, compared to 50% of those who were not (difference of 41%; 95% CI 18–63%). Resistance percentages found in isolates of the placebo group were: 4% to clarithromycin, 19% to metronidazole, 1% to amoxicillin and 2% to tetracycline.