Language
English
Publication Date
1-1-2024
Journal
Helicobacter
DOI
10.1111/hel.13112
PMID
39085988
PMCID
PMC11983701
PubMedCentral® Posted Date
4-10-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
Background and aim: Helicobacter pylori infections have become resistant to many previously highly effective antimicrobial regimens resulting in clarithromycin, metronidazole, or fluoroquinolone-containing therapies becoming unsuccessful. Pretreatment susceptibility testing is only widely available in the United States but is still rarely done. Here, we propose a framework to monitor H. pylori eradication in small clinical settings by routinely assessing the effectiveness of therapy.
Methods: Because of the small sample size in individual practice's, we assume an acceptable cure rate of ≥80% (preferred cure rate ≥85%) in adherent patients, with a dichotomous outcome (cured vs. failed) and consecutive patient enrollment. To obtain results (feedback) in a timely manner, for individual practices, cure rates can be estimated after 10 patients. Large practices which acquire patients more rapidly can delay analysis until a total of 104 H. pylori-infected patients, assuming a baseline cure rate of at least 85% with the preferred regimen.
Results: We show how data from individual practices can be utilized to improve the effectiveness of H. pylori treatment decisions. The method consists of recording and accumulating the confirmation of cure data for successive small groups of patients. These data are then analyzed as binary outcomes (pass-fail) and serve as the basis for studying and improving the effectiveness of H. pylori treatment decisions.
Conclusion: A simple actuarial method can serve outpatient clinics to ensure a reliable test-to-cure method and avoid futile Hp regimens.
Keywords
Helicobacter Infections, Humans, Helicobacter pylori, Anti-Bacterial Agents, Treatment Outcome, antibiotic resistance, clinical practice, confirmation of cure, Helicobacter pylori, therapy
Published Open-Access
yes
Recommended Citation
Maria Pina Dore, Ruben Hernaez, and David Y Graham, "Self-Correcting Method for Highly Effective Office-Based Helicobacter pylori Therapy Using Cumulative Test of Cure Data" (2024). Faculty and Staff Publications. 4135.
https://digitalcommons.library.tmc.edu/baylor_docs/4135