Management of Helicobacter pylori infection

BMJ 1998;316:1244 ( 18 April )

Letters

Management of Helicobacter pylori infection

Eradication treatment should be limited to patients with proved peptic ulceration

Authors' reply

Eradication treatment should be limited to patients with proved peptic ulceration

The first 150 words of the full text of this article appear below.

EDITOR $---$ Benefits from treating Helicobacter pylori infection may depend less on the choice of eradication regimen than on theselection of patients to be treated. Rauws and van der Hulst makesound recommendations for the former at the expense of misleadingon the latter.¹ Their advice to general practitioners to testand prescribe eradication treatment in dyspeptic patients agedunder 45 reflects that of the European Helicobacter Study Group²;neither set of recommendations is evidence based.

Both sets of recommendations advocate the safety net of specialist referral when eradication has failed in primary care. Thisignores the reality that fewer than one quarter of dyspeptic patientswith H pylori infection have peptic ulcer disease and that onlythis group of patients can be confidently expected to benefitfrom eradication treatment.³ Treating all dyspeptic patientsinfected with H pylori would therefore result in most of thosewith non-ulcer dyspepsia or . . . [Full text of this article]