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- Title
Efficacy of serology driven "test and treat strategy" for eradication of H. pylori in patients with rheumatic disease in the Netherlands.
- Authors
de Leest, H T J I; Steen, K S S; Lems, W F; van de Laar, M A F J; Huisman, A M; Kadir, S W; Houben, H H M L; Kostense, P J; Kuipers, E J; Dijkmans, B A C; Debets-Ossenkopp, Y J
- Abstract
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.
- Publication
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2011, Vol 30, Issue 7, p903
- ISSN
1435-4373
- Publication type
Journal Article
- DOI
10.1007/s10096-011-1174-5