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- Title
The diagnosis and management of H. pylori infection in Singapore.
- Authors
Chew, Claire Alexandra Zhen; Tong Fong Lye; Ang, Daphne; Tiing Leong Ang; Lye, Tong Fong; Ang, Tiing Leong
- Abstract
Helicobacter pylori (H. pylori) is an infection that has a role in causing dyspepsia and complications such as peptic ulcer disease and gastric malignancies. In the primary care setting, one can adopt a stepwise approach with the 'test-and-treat' strategy to manage H. pylori-associated dyspepsia in young patients without alarm symptoms. Empiric first-line therapies should be for a two-week duration; options include clarithromycin-containing triple therapy alone or with the addition of bismuth, concomitant therapy and bismuth quadruple therapy. Post-treatment carbon urea breath test must be performed at least four weeks after the end of treatment to confirm the cure. Options for empiric second-line treatment include bismuth quadruple therapy and levofloxacin-containing triple therapy. Patients with persistent or alarm symptoms should be referred for further evaluation. Patients with persistent infection should be referred for gastroscopy so that gastric biopsies can be obtained for H. pylori culture and antibiotic susceptibility testing.
- Subjects
SINGAPORE; HELICOBACTER pylori infections; HELICOBACTER; PEPTIC ulcer; ULCER treatment; INDIGESTION; DIAGNOSIS; PATIENTS; ANTACIDS; ANTIBIOTICS; BISMUTH; HELICOBACTER disease diagnosis; CLARITHROMYCIN; QUINOLONE antibacterial agents; BREATH tests; COMBINATION drug therapy; GASTROSCOPY; HELICOBACTER diseases; HELICOBACTER pylori; DISEASE complications; THERAPEUTICS
- Publication
Singapore Medical Journal, 2017, Vol 58, Issue 5, p234
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2017037