2.5 Treatment of H. pylori Infection
The goal of treatment of H. pylori infection is complete eradication of the organism. Eradication is currently defined as absence of H. pylori for a minimum of 4 weeks after treatment, as confirmed by biopsy-based test, UBT or stool antigen test (142). Clinically relevant eradication regimens must have cure rates of at least 80%, according to intention-to-treat analysis, without major side effects and with minimal induction of bacterial resistance (10).
2.5.1 Indications for treatment
Eradication of H. pylori infection is an effective way to cure H. pyloriassociated peptic ulcer disease, as it facilitates ulcer healing, prevents recurrences in vast majority of patients (108), and significantly reduces the …show more content…
Recurrence is the result of either reinfection or recrudescence. Recrudescence is a situation where the pre-treatment strain of H. pylori, which was suppressed by treatment and was undetectable one month after treatment, becomes detectable at a later stage, usually within first three months after treatment (77).
Reinfection is acquisition of a new infection, either a new strain of H. pylori or a genetically identical strain, after the original strain of H. pylori has been completely eradicated (173). Due to the high grade of genetic diversity of H. pylori strains among unrelated patients, distinguishing between recrudescence and true reinfection by comparing pre- and post-treatment isolates by genotyping methods is suggested (173). However, the results …show more content…
The recurrence rate during the first 6–12 months is inversely associated with the efficacy of the original course of eradication therapy (175). This suggests that in cases of low effective treatment, most recurrences that occur shortly after treatment are actually recrudescence (77). The risk of reinfection appears to be different in different regions of the world. In industrialized countries, reinfection is a rare event: the reported recurrence rates in adults are generally lower than 2% per patient per year. The lowest recurrence rate,
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virtually no recurrences during 2 years after treatment has been reported in a study conducted in Germany (176).
In developing countries, the reported recurrence rates are variable, being generally higher than 5% per patient-year. The highest reinfection rates,
>15% per patient-year, have been reported from Peru and Bangladesh (177).
A recurrence rate as low as 1.1% per patient-year was found in a study conducted in China
The goal of treatment of H. pylori infection is complete eradication of the organism. Eradication is currently defined as absence of H. pylori for a minimum of 4 weeks after treatment, as confirmed by biopsy-based test, UBT or stool antigen test (142). Clinically relevant eradication regimens must have cure rates of at least 80%, according to intention-to-treat analysis, without major side effects and with minimal induction of bacterial resistance (10).
2.5.1 Indications for treatment
Eradication of H. pylori infection is an effective way to cure H. pyloriassociated peptic ulcer disease, as it facilitates ulcer healing, prevents recurrences in vast majority of patients (108), and significantly reduces the …show more content…
Recurrence is the result of either reinfection or recrudescence. Recrudescence is a situation where the pre-treatment strain of H. pylori, which was suppressed by treatment and was undetectable one month after treatment, becomes detectable at a later stage, usually within first three months after treatment (77).
Reinfection is acquisition of a new infection, either a new strain of H. pylori or a genetically identical strain, after the original strain of H. pylori has been completely eradicated (173). Due to the high grade of genetic diversity of H. pylori strains among unrelated patients, distinguishing between recrudescence and true reinfection by comparing pre- and post-treatment isolates by genotyping methods is suggested (173). However, the results …show more content…
The recurrence rate during the first 6–12 months is inversely associated with the efficacy of the original course of eradication therapy (175). This suggests that in cases of low effective treatment, most recurrences that occur shortly after treatment are actually recrudescence (77). The risk of reinfection appears to be different in different regions of the world. In industrialized countries, reinfection is a rare event: the reported recurrence rates in adults are generally lower than 2% per patient per year. The lowest recurrence rate,
49
virtually no recurrences during 2 years after treatment has been reported in a study conducted in Germany (176).
In developing countries, the reported recurrence rates are variable, being generally higher than 5% per patient-year. The highest reinfection rates,
>15% per patient-year, have been reported from Peru and Bangladesh (177).
A recurrence rate as low as 1.1% per patient-year was found in a study conducted in China