Efficacy of serology driven "test and treat strategy" for eradication of H. Pylori in patients with rheumatic diseases in the Netherlands

H.T.J.I. de Leest, K.S.S. Steen, W.F. Lems, Mart 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

Research output: Contribution to journalArticleAcademicpeer-review

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.
Original languageEnglish
Pages (from-to)903-908
JournalEuropean journal of clinical microbiology & infectious diseases
Volume30
Issue number7
DOIs
Publication statusPublished - 2011

Keywords

  • IR-83578
  • METIS-282227

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