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Helicobacter pylori eradication in the Swedish population

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Abstract
Objectives: 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 7days. 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. Materials and methods: 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. Results: We identified 157,915 eradication episodes in 140,391 individuals (53.8% women, 42.6% older than 60years), 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 80years (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%). Conclusions: 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.
Keywords
Helicobacter pylori, eradication, population-based, epidemiology, Sweden, antibiotics, TRIPLE THERAPY, QUADRUPLE THERAPY, GASTRIC-CANCER, BISMUTH, LEVOFLOXACIN, RESISTANCE, CLARITHROMYCIN, TETRACYCLINE, METAANALYSIS, AMOXICILLIN

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Chicago
Doorakkers, Eva, Jesper Lagergren, Vijaya Krishna Gajulapuri, Steven Callens, Lars Engstrand, and Nele Brusselaers. 2017. “Helicobacter Pylori Eradication in the Swedish Population.” Scandinavian Journal of Gastroenterology 52 (6-7): 678–685.
APA
Doorakkers, E., Lagergren, J., Gajulapuri, V. K., Callens, S., Engstrand, L., & Brusselaers, N. (2017). Helicobacter pylori eradication in the Swedish population. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 52(6-7), 678–685.
Vancouver
1.
Doorakkers E, Lagergren J, Gajulapuri VK, Callens S, Engstrand L, Brusselaers N. Helicobacter pylori eradication in the Swedish population. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY. 2017;52(6-7):678–85.
MLA
Doorakkers, Eva, Jesper Lagergren, Vijaya Krishna Gajulapuri, et al. “Helicobacter Pylori Eradication in the Swedish Population.” SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 52.6-7 (2017): 678–685. Print.
@article{8517903,
  abstract     = {Objectives: 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 7days. 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.
Materials and methods: 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.
Results: We identified 157,915 eradication episodes in 140,391 individuals (53.8\% women, 42.6\% older than 60years), 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 80years (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\%).
Conclusions: 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.},
  author       = {Doorakkers, Eva and Lagergren, Jesper and Gajulapuri, Vijaya Krishna and Callens, Steven and Engstrand, Lars and Brusselaers, Nele},
  issn         = {0036-5521},
  journal      = {SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY},
  keyword      = {Helicobacter pylori,eradication,population-based,epidemiology,Sweden,antibiotics,TRIPLE THERAPY,QUADRUPLE THERAPY,GASTRIC-CANCER,BISMUTH,LEVOFLOXACIN,RESISTANCE,CLARITHROMYCIN,TETRACYCLINE,METAANALYSIS,AMOXICILLIN},
  language     = {eng},
  number       = {6-7},
  pages        = {678--685},
  title        = {Helicobacter pylori eradication in the Swedish population},
  url          = {http://dx.doi.org/10.1080/00365521.2017.1303844},
  volume       = {52},
  year         = {2017},
}

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