Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradication therapy were considered.

Patients who tested positive for H. pylori infection using a rapid urease test (RUT) during a three-year period were evaluated retrospectively according to demographics, eradication rate, type of eradication therapy, endoscopic findings and number of former attempts of eradication therapy. RUT-positive patients without a post-treatment evaluation were invited for a urea breath test.

The overall H. pylori infection rate was 15% (117/796). Only 48/105 (46%) patients had a post-treatment examination to test the effect of H. pylori eradication therapy. The eradication rate by first-line therapy was 75% (58/77). The second-line eradication rate was 87%. 94% (72/77) had the recommended standard triple therapy for first-line eradication therapy. The number of former eradication attempts was the only clinical characteristic that significantly predicted failure of eradication therapy. Among patients with H. pylori-positive peptic ulcer, 21/28 (75%) achieved successful eradication after first-line treatment.

Organised follow-up regimes are recommended, especially in patients with absolute treatment indications with a view to optimizing the care for patients infected with H. pylori.