Doorakkers Eva, Lagergren Jesper, Gajulapuri Vijaya Krishna, Callens Steven, Engstrand Lars, Brusselaers Nele
a Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
b Division of Cancer Studies , King's College London , London , UK.
Scand J Gastroenterol. 2017 Jun-Jul;52(6-7):678-685. doi: 10.1080/00365521.2017.1303844. Epub 2017 Mar 21.
Helicobacter pylori is associated with peptic ulcers and gastric cancer and its eradication aims to prevent these conditions. The recommended eradication regimen is triple therapy, consisting of a proton-pump inhibitor in combination with clarithromycin and amoxicillin or metronidazole for 7 days. Yet, other antibiotic regimens are sometimes prescribed. We aimed to assess the use of eradication therapy for H. pylori in the Swedish population during the last decade.
This population-based study used data from the Swedish Prescribed Drug Register. From July 2005 until December 2014, all regimens that can eradicate H. pylori were identified and evaluated according to patients' age and sex and calendar year of eradication.
We identified 157,915 eradication episodes in 140,391 individuals (53.8% women, 42.6% older than 60 years), who correspond to 1.5% of the Swedish population. The absolute number and incidence of eradications decreased over the study period. Overall, 91.0% had one eradication and 0.1% had more than three. Of all eradications, 95.4% followed the recommended regimen, while 4.7% did not. The latter group was overrepresented among individuals aged ≥80 years (7.8%). Amoxicillin and clarithromycin were most frequently prescribed, while metronidazole was rarely used (0.01%). Other prescribed antibiotics were ciprofloxacin (2.4%), doxycycline (1.4%), nitrofurantoin (0.7%), norfloxacin (0.5%) and erythromycin (0.3%).
During the last decade in Sweden H. pylori eradication has been frequently prescribed, but the incidence of eradication has slowly declined. Most eradications followed the recommended regimen, including those occurring after a previous eradication.
幽门螺杆菌与消化性溃疡和胃癌相关，根除幽门螺杆菌旨在预防这些疾病。推荐的根除方案是三联疗法，即质子泵抑制剂联合克拉霉素和阿莫西林或甲硝唑，疗程为7天。然而，有时也会开出其他抗生素方案。我们旨在评估过去十年瑞典人群中幽门螺杆菌根除疗法的使用情况。
这项基于人群的研究使用了瑞典处方药登记处的数据。从2005年7月到2014年12月，识别出所有可根除幽门螺杆菌的方案，并根据患者的年龄、性别和根除年份进行评估。
我们在140391名个体中识别出157915次根除事件（女性占53.8%，60岁以上者占42.6%），这相当于瑞典人口的1.5%。在研究期间，根除的绝对数量和发生率有所下降。总体而言，91.0%的人进行了一次根除，0.1%的人进行了三次以上根除。在所有根除治疗中，95.4%遵循了推荐方案，而4.7%没有。后一组在80岁及以上个体中占比过高（7.8%）。阿莫西林和克拉霉素的处方最为频繁，而甲硝唑很少使用（0.01%）。其他处方抗生素包括环丙沙星（2.4%）、强力霉素（1.4%）、呋喃妥因（0.7%）、诺氟沙星（0.5%）和红霉素（0.3%）。
在过去十年中，瑞典经常开出幽门螺杆菌根除治疗的处方，但根除率已缓慢下降。大多数根除治疗遵循了推荐方案，包括之前根除治疗后进行的治疗。
