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Management of Helicobacter pylori infection in Latin America: a Delphi technique-based consensus.

作者信息

Rollan Antonio, Arab Juan Pablo, Camargo M Constanza, Candia Roberto, Harris Paul, Ferreccio Catterina, Rabkin Charles S, Gana Juan Cristóbal, Cortés Pablo, Herrero Rolando, Durán Luisa, García Apolinaria, Toledo Claudio, Espino Alberto, Lustig Nicole, Sarfatis Alberto, Figueroa Catalina, Torres Javier, Riquelme Arnoldo

机构信息

Antonio Rollan, Pablo Cortés, Luisa Durán, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7650568, Chile.

出版信息

World J Gastroenterol. 2014 Aug 21;20(31):10969-83. doi: 10.3748/wjg.v20.i31.10969.


DOI:10.3748/wjg.v20.i31.10969
PMID:25152601
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4138478/
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. 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. 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. CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes.

摘要

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Management of Helicobacter pylori infection in Latin America: a Delphi technique-based consensus.

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本文引用的文献

[1]
The problem of Helicobacter pylori resistance to antibiotics: a systematic review in Latin America.

Am J Gastroenterol. 2014-3-4

[2]
What do we know about benefits of H. pylori treatment in childhood?

Gut Microbes. 2013-11-6

[3]
Risk of recurrent Helicobacter pylori infection 1 year after initial eradication therapy in 7 Latin American communities.

JAMA. 2013-2-13

[4]
Improved efficacy of proton pump inhibitor - amoxicillin - clarithromycin triple therapy for Helicobacter pylori eradication in low clarithromycin resistance areas or for tailored therapy.

Helicobacter. 2013-1-29

[5]
Eradication of Helicobacter pylori reduces metachronous gastric cancer after endoscopic resection of early gastric cancer.

Hepatogastroenterology. 2013-6

[6]
Sequential versus triple therapy for the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial.

Lancet. 2012-11-16

[7]
Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line.

World J Gastroenterol. 2012-10-28

[8]
Standard triple and sequential therapies for Helicobacter pylori eradication: an update.

Eur J Intern Med. 2012-8-9

[9]
Meta-analysis: sequential therapy for Helicobacter pylori eradication in children.

Aliment Pharmacol Ther. 2012-7-25

[10]
Helicobacter  pylori Eradication Therapies in the Era of Increasing Antibiotic Resistance: A Paradigm Shift to Improved Efficacy.

Gastroenterol Res Pract. 2012-6-19

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