000125363 001__ 125363
000125363 005__ 20231108202308.0
000125363 0247_ $$2doi$$a10.1111/hel.12957
000125363 0248_ $$2sideral$$a133142
000125363 037__ $$aART-2023-133142
000125363 041__ $$aeng
000125363 100__ $$aAriño-Pérez, I.
000125363 245__ $$aMistakes in the diagnosis and treatment of Helicobacter pylori infection in daily clinical practice
000125363 260__ $$c2023
000125363 5060_ $$aAccess copy available to the general public$$fUnrestricted
000125363 5203_ $$aBackground: An adequate diagnostic and therapeutic approach to Helicobacter pylori (H. pylori) infection is the cornerstone to avoid overdiagnosis, overuse of health resources, and increase in antibiotic resistances. The aim of the study was to evaluate the most common errors in clinical practice and the associated risk factors. Materials and Methods: This is a retrospective observational study including patients with H. pylori infection and no previous treatment belonging to two defined areas of the National Health System in Spain; some of them were enrolled in the European Registry on H. pylori management (Hp-EuReg). Patients were attended by gastroenterologists between 2010 and 2019. According to current guidelines, we evaluated indications for H. pylori investigation, appropriateness of diagnostic test used in dyspeptic patients and discontinuation of surveillance after treatment. Results: A total of 1730 patients were included, receiving 2260 eradication regimens. H. pylori infection was investigated in 1.7% cases in absence of a formal indication. Oral endoscopy was incorrectly used in 56% of patients with dyspepsia under 55 years without alarm signs, and urea breath test (UBT) was incorrectly used in 22.4% of patients with dyspepsia ≥55 years or red flags. Levofloxacin containing regimens were used as first-line therapy in 7.5% of non-allergic to penicillin patients. After first-line failure, clarithromycin was repeated in 2.6% of the patients who received second-line therapy. Confirmatory test of H. pylori status was absent in 2.5% cases. Men, patients under 55 years, and patients diagnosed by UBT had a higher risk of not undergoing a confirmatory test. Conclusions: Investigation of H. pylori infection by gastroenterologists is rare in absence of a formal indication; however, endoscopy is commonly used for dyspeptic patients <55 years without red flags and non-invasive tests are still used for dyspeptic patients ≥55 years or presenting alarm signs. Men, patients under 55 years, and patients diagnosed by UBT have an increased risk of being lost to follow-up after eradication treatment.
000125363 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000125363 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000125363 700__ $$aMartínez-Domínguez, S. J.$$uUniversidad de Zaragoza
000125363 700__ $$aAlfaro Almajano, E.
000125363 700__ $$aCarrera-Lasfuentes, P.
000125363 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, Á.$$uUniversidad de Zaragoza
000125363 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000125363 773__ $$g28, 4 (2023), e12957 [7 pp.]$$pHelicobacter$$tHELICOBACTER$$x1083-4389
000125363 8564_ $$s430911$$uhttps://zaguan.unizar.es/record/125363/files/texto_completo.pdf$$yPostprint
000125363 8564_ $$s2077152$$uhttps://zaguan.unizar.es/record/125363/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000125363 909CO $$ooai:zaguan.unizar.es:125363$$particulos$$pdriver
000125363 951__ $$a2023-11-08-20:19:52
000125363 980__ $$aARTICLE