Treatment regimens used in the management of Helicobacter pylori in Colombia

Braz J Infect Dis. 2022 Jan-Feb;26(1):102331. doi: 10.1016/j.bjid.2022.102331. Epub 2022 Feb 16.

Abstract

Background: Helicobacter pylori infection can cause gastritis, gastric ulcers, duodenal ulcers, and gastric cancer. Its treatment involves different medications, but resistance to these treatments is increasing. It is currently considered a public health problem.

Aims: to identify regimens used for H. pylori eradication by age group, year of treatment and geographical region of Colombia.

Methods: A cross-sectional study that identified regimens used H. pylori eradication in outpatient consultations over a 6-year period based on a medication dispensing database of 8.5 million people affiliated to the Colombian Health System. The appropriate regimens were those that included a proton pump inhibitor, associated with two antibiotics recommended by clinical practice guidelines (amoxicillin, clarithromycin, levofloxacin, moxifloxacin, tetracycline, doxycycline, metronidazole, tinidazole, and furazolidone).

Results: A total of 12,011 patients with a diagnosis of acid-peptic disease and H. pylori infection were identified, who had undergone 12,426 eradication treatment courses. Of these, 98.0% used a proton pump inhibitor (PPI), and 91.1% used amoxicillin. A total of 56.1% of the regimens were considered adequate; of these, 42.0% were a combination of PPI, amoxicillin/clarithromycin. This regimen predominated between 2015 and 2017 for all age groups.

Conclusions: The management of H. pylori infection in the majority of patients is heterogeneous and inconsistent with current recommendations based on evidence of antimicrobial resistance.

Keywords: Amoxicillin; Clarithromycin; Helicobacter pylori; Inappropriate prescribing; Metronidazole; Proton pump inhibitors.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Clarithromycin / therapeutic use
  • Colombia
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori*
  • Humans
  • Metronidazole / pharmacology

Substances

  • Anti-Bacterial Agents
  • Metronidazole
  • Clarithromycin