Management of Helicobacter pylori infection

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7139.1244b (Published 18 April 1998) Cite this as: BMJ 1998;316:1244

Eradication treatment should be limited to patients with proved peptic ulceration

  1. Robbie Foy, Senior registrar in public health,
  2. Jayne Parry, Lecturer in public health,
  3. Ciaran Woodman, Professor of public health and cancer epidemiology
  1. National Primary Care Research and Development Centre, University of Manchester M13 9PL
  2. Centre for Cancer Epidemiology, University of Manchester, Manchester M20 4QL
  3. Department of Gastroenterology and Hepatology, Academic Medical Centre Amsterdam, Postbox 22700, 1100 DE Amsterdam, Netherlands

    EDITOR—Benefits from treating Helicobacter pylori infection may depend less on the choice of eradication regimen than on the selection of patients to be treated. Rauws and van der Hulst make sound recommendations for the former at the expense of misleading on the latter.1 Their advice to general practitioners to test and prescribe eradication treatment in dyspeptic patients aged under 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. This ignores the reality that fewer than one quarter of dyspeptic patients with H pylori infection have peptic ulcer disease and that only this group of patients can be confidently expected to …

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