Eradication treatment for Helicobacter pylori in general practice

Area of Science:

• Gastroenterology
• General Practice
• Infectious Disease

Background:

• Peptic ulcer disease management requires accurate diagnosis and treatment of Helicobacter pylori infection.
• H2-receptor antagonists are commonly prescribed for various gastrointestinal symptoms.
• Identifying patients with a history of peptic ulcer is crucial for targeted treatment.

Purpose of the Study:

• To identify patients with a history of peptic ulcer within a general practice setting.
• To assess the prevalence of Helicobacter pylori infection in these patients.
• To evaluate the effectiveness of recall and treatment strategies.

Main Methods:

• Review of general practitioner patient records for H2-receptor antagonist prescribing and upper gastrointestinal investigations.
• Identification and recall of patients with a documented history of peptic ulcer.
• Utilizing the 13C urea breath test to detect Helicobacter pylori infection.

Main Results:

• 267 patients used H2-receptor antagonists; indications varied, with peptic ulcer accounting for 25%.
• 52% of patients received short-term H2-receptor antagonist prescriptions, often for undiagnosed dyspepsia.
• Of 96 identified peptic ulcer patients, 38 underwent a 13C urea breath test, revealing a 60.5% Helicobacter pylori positivity rate.
• Eradication treatment was successful in 73% of treated patients.

Conclusions:

• General practice case notes are effective for identifying and recalling patients with peptic ulcer disease.
• Antibiotic treatment can successfully manage Helicobacter pylori infection in these patients.
• The majority of H2-receptor antagonist prescriptions are for indications other than peptic ulcer disease, highlighting potential areas for guideline review.