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Management of Helicobacter pylori infection in Latin America: a Delphi technique-based consensus.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2014 Aug 21; Vol. 20 (31), pp. 10969-83. - Publication Year :
- 2014
-
Abstract
- Aim: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.<br />Methods: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria.<br />Results: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included: (1) when available, urea breath and stool antigen test (HpSA) should be used for non-invasive diagnosis; (2) detect and eradicate Helicobacter pylori (H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer; (3) further investigate implementation issues and health outcomes of H. pylori eradication for primary prevention of gastric cancer in high-risk populations; (4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment; (5) routinely assess eradication success post-treatment in clinical settings; and (6) select second- and third-line therapies according to antibiotic susceptibility testing.<br />Conclusion: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes.
- Subjects :
- Bacteriological Techniques
Consensus
Disease Progression
Drug Resistance, Bacterial
Drug Therapy, Combination
Helicobacter Infections diagnosis
Helicobacter Infections epidemiology
Helicobacter Infections microbiology
Helicobacter pylori isolation & purification
Humans
Latin America epidemiology
Peptic Ulcer epidemiology
Peptic Ulcer microbiology
Peptic Ulcer prevention & control
Practice Guidelines as Topic
Precancerous Conditions drug therapy
Precancerous Conditions epidemiology
Precancerous Conditions microbiology
Predictive Value of Tests
Recurrence
Stomach Neoplasms epidemiology
Stomach Neoplasms microbiology
Stomach Neoplasms prevention & control
Time Factors
Treatment Outcome
Anti-Bacterial Agents therapeutic use
Delphi Technique
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Proton Pump Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 20
- Issue :
- 31
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 25152601
- Full Text :
- https://doi.org/10.3748/wjg.v20.i31.10969