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Lack of symptom benefit following presumptive Helicobacter pylori eradication therapy in primary care
Author(s) -
Williams D.,
O'Kelly P.,
Kelly A.,
Feely J.
Publication year - 2001
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2001.01100.x
Subject(s) - medicine , helicobacter pylori , helicobacter infections , primary care , intensive care medicine , spirillaceae , gastroenterology , gastritis , family medicine
Background: Helicobacter pylori eradication regimens have failure rates under 10%, however little information is available on the effect of treatment success in reducing the subsequent prescription of anti‐ulcer medications in primary care. Aims: To determine, using a large prescription database in eastern Ireland, the success of presumptive eradication therapy in improving symptoms of dyspepsia in primary care, as judged by a reduction in the subsequent prescription of anti‐ulcer medications. Methods: In a cross‐sectional study, we identified 3847 patients who received a prescription for eradication therapy for Helicobacter pylori , including 826 who were followed for 9–11 months. Those who subsequently received anti‐ulcer medications were deemed failures to obtain symptom relief. Results: For 3847 patients with a median follow‐up of 8 months, the failure rate was 49%. Of 826 patients, followed for a longer period (9–11 months), the overall failure rate was 56% (range 44–62% depending on the eradication regimen used). Age over 65 years (hazard ratio=1.57, 95% confidence interval= 1.29–1.91, P < 0.001), prior use of anti‐ulcer medications (hazard ratio=1.97, 95% confidence interval=1.63–2.37, P < 0.001) and prior use of aspirin/NSAIDs (hazard ratio=1.43, 95% confidence interval=1.18–1.73, P < 0.001) all predicted failure to obtain relief of symptoms of dyspepsia from eradication therapy. Conclusions: Such high failure rates of eradication therapy in reducing the subsequent consumption of anti‐ulcer medications have both clinical and economic implications for the use of eradication therapy for Helicobacter pylori in primary care.