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11. The nonadherence and risk factors of eradication failure by sequential therapy as first‐line anti‐Helicobacter pylori treatment in real‐world clinical practice.

Author

Lee, Chun‐Te, Wu, Chung‐Tai, Chang, Wei‐Lun, Yang, Er‐Hsiang, Hsieh, Ming‐Tsung, Chen, Wei‐Ying, Sheu, Bor‐Shyang, and Cheng, Hsiu‐Chi

Subjects
HELICOBACTER pylori infections, PATIENT compliance, HELICOBACTER pylori, MEDICATION reconciliation, TREATMENT failure, ODDS ratio
Abstract

Background: The eradication rates of sequential therapy are high in clinical trials; however, the adherence for follow‐up or the patient population in a real‐world setting might be different from those in trails. This study investigates the effectiveness of sequential therapy in a real‐world setting and the factors that lead to treatment failure. Materials and Methods: In this retrospective study, patients receiving sequential therapy as a first‐line anti‐Helicobacter pylori (H. pylori) treatment in a real‐world setting were reviewed. The age adjusted Charlson Comorbidity Index (age‐CCI) and baseline variety of medications were reviewed to determine factors correlated with nonadherence for post‐treatment testing and H. pylori eradication failure. Results: A total of 1053 patients were reviewed. A total of 579 patients receiving sequential therapy were included in the analyses. Among them, 462 received post‐treatment testing and were placed into the follow‐up group. Thus, the post‐treatment testing rate was 79.8%. Stroke was an independent factor of nonadherence for post‐treatment testing. In the follow‐up group, the eradication failure rate was 8.2%. Female sex (odds ratio [OR] 2.41 [95% CI 1.16–5.03], p = 0.02) and age‐CCI ≥2 (OR 3.16 [1.05–9.48], p = 0.04) were independent factors of H. pylori eradication failure. The eradication failure rates were 14.4%, 7.8%, 7.1%, and 3.1% for the females with age‐CCI ≥2, females with age‐CCI <2, males with age‐CCI ≥2, and males with age‐CCI <2 subgroups, respectively (p = 0.027). Conclusions: In a real‐world setting, the adherence rate of post‐treatment testing for sequential therapy as a first‐line anti‐H. pylori treatment was found to be suboptimal. Female sex and age‐CCI ≥2 were independent factors of eradication failure. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial

Author

Liou, Jyh-Ming, Fang, Yu-Jen, Chen, Chieh-Chang, Bair, Ming-Jong, Chang, Chi-Yang, Lee, Yi-Chia, Chen, Mei-Jyh, Chen, Chien-Chuan, Tseng, Cheng-Hao, Hsu, Yao-Chun, Lee, Ji-Yuh, Yang, Tsung-Hua, Luo, Jiing-Chyuan, Chang, Chun-Chao, Chen, Chi-Yi, Chen, Po-Yueh, Shun, Chia-Tung, Hsu, Wen-Feng, Hu, Wen-Hao, Chen, Yen-Nien, Sheu, Bor-Shyang, Lin, Jaw-Town, Wu, Jeng-Yih, El-Omar, Emad M, and Wu, Ming-Shiang

Published
2016
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22. A Culture-Based Strategy Is More Cost Effective Than an Empiric Therapy Strategy in Managing Pediatric Helicobacter pylori Infection

Author

Hung, Chi-Wen, Chen, Solomon Chih-Chen, Ku, Li-Jung Elizabeth, Sheu, Bor-Shyang, and Yang, Yao-Jong

Subjects
Pediatrics, Perinatology and Child Health
Abstract

BackgroundHelicobacter pylori infection is a major cause of peptic ulcers and gastric cancer. This study aimed to compare the eradication rate and essential costs of culture-based and empiric therapy strategies in treating pediatric H. pylori infection.MethodsWe retrospectively enrolled patients aged H. pylori infection who received esophagogastroduodenoscopy at two medical centers in southern Taiwan from 1998 to 2018. Patients with positive cultures and minimum inhibitory concentration test results were allocated to a culture-based strategy, and those with negative cultures or without culture as an empiric therapy strategy. We collected demographic data and eradication rates, and calculated the total essential costs of treating a hypothetical cohort of 1,000 pediatric patients based on the two strategies.ResultsNinety-six patients were enrolled, of whom 55 received a culture-based strategy and 41 received an empiric therapy strategy. The eradication rates with the first treatment were 89.1 and 75.6% in the culture-based and empiric therapy strategy, respectively. There were no significant differences in age, sex, and endoscopic diagnosis between the two strategies. For every 10% increase in those receiving a culture-based strategy, the total cost would have been reduced by US$466 in a hypothetical cohort of 1,000 patients. For every 10% increase in successful eradication rate, the total cost was reduced by US$24,058 with a culture-based strategy and by US$20,241 with an empiric therapy strategy.ConclusionsA culture-based strategy was more cost effective than an empiric therapy strategy in treating pediatric H. pylori-infected patients.

Published
2022
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