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首页> 外文期刊>European journal of gastroenterology and hepatology >Helicobacter pylori eradication therapy: a discrepancy between current guidelines and clinical practice.
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Helicobacter pylori eradication therapy: a discrepancy between current guidelines and clinical practice.

机译：幽门螺杆菌根除疗法：当前指南与临床实践之间存在差异。

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BACKGROUND: Consensus guidelines recommend that patients with peptic ulcer disease, and other causes of dyspepsia, should be treated with Helicobacter pylori eradication regimens. However, it has not been firmly established whether physicians have adapted their practice accordingly. OBJECTIVES: (1) To establish the proportion of ulcer-healing prescriptions that H. pylori eradication regimens accounted for, (2) to evaluate the composition of the eradication regimens used, and (3) to compare the prescribing patterns of specialist and primary care practitioners. METHODS: Seven community pharmacy practices were identified, and all prescriptions for individual acid-suppressing agents and eradication regimens were prospectively evaluated over an initial one-month period. Prospective documentation and evaluation of eradication regimens only was then continued for a further three-month period. RESULTS: The prescriptions for 585 patients were evaluated. Proton-pump inhibitors and H2-receptor antagonists accounted for 261 (44.5%) and 307 (52.5%) of prescriptions respectively. H. pylori eradication therapy was prescribed for 17 (2.9%) patients in this initial period. Sixty-six eradication regimens were evaluated over four months: 48/66 (73%) of these were initiated by primary care practitioners and 18/66 (27%) by specialists. Thirteen different combinations of antibiotics and acid-suppressing agents were identified - many of undocumented efficacy. Dual, triple and quadruple regimens accounted for 15 (23%), 48 (72.5%) and 3 (4.5%) of patient prescriptions respectively. CONCLUSION: H. pylori eradication therapy currently accounts for a very small proportion of ulcer-healing medication in clinical practice. Most eradication regimens are initiated by primary care practitioners. In comparison with specialist practices, prescriptions from this source are more likely to be of undocumented efficacy.
机译：背景：共识性指南建议患有消化性溃疡疾病和其他消化不良原因的患者应采用幽门螺杆菌根除方案治疗。然而，尚未确定医生是否相应地调整了自己的实践。目的：（1）确定幽门螺杆菌根除方案占溃疡愈合处方的比例，（2）评估所用根除方案的组成，（3）比较专科医生和初级保健的处方模式从业者。方法：确定了七个社区药房实践，并在最初的一个月内前瞻性地评估了每种酸抑制剂和根除方案的所有处方。然后，仅对根除方案的前瞻性文件和评估再进行了三个月。结果：对585名患者的处方进行了评估。质子泵抑制剂和H2受体拮抗剂分别占处方的261（44.5％）和307（52.5％）。在此初始阶段，已针对17例（2.9％）患者开出了根除幽门螺杆菌的疗法。在四个月中评估了66种根除方案：其中48/66（73％）由初级保健从业者发起，18/66（27％）由专家发起。鉴定出了十三种不同的抗生素和抑酸剂组合-许多未记录的功效。双重，三重和四重方案分别占患者处方的15（23％），48（72.5％）和3（4.5％）。结论：目前在临床实践中，根除幽门螺杆菌的治疗溃疡治疗药物的比例很小。大多数根除方案是由初级保健从业者发起的。与专业实践相比，这种来源的处方更有可能没有记载的功效。

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