Scandinavian journal of gastroenterology. Supplement
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Scand. J. Gastroenterol. Suppl. · Jan 1996
Comparative StudyCost-effectiveness of Helicobacter pylori eradication therapy in duodenal ulcer disease.
A model analysis applied to Helicobacter pylori eradication found that, following successful healing with omeprazole and H. pylori eradication, virtually all patients were cured and experienced no relapse during the next 5 years. In contrast, almost all of the patients receiving episodic therapy relapsed and, during maintenance therapy with H2-receptor antagonists, most experienced at least one relapse. Although H. pylori eradication initially resulted in higher costs than the alternative therapies, it reduced the risk of recurrence and, for most patients, no future costs were incurred. ⋯ These regimens were also shown to be the most cost-effective. As the difference in costs between the therapies is small compared with the savings that can be achieved by successful H. pylori eradication, it is logical that the eradication strategy with the highest eradication rate is the most cost-effective. The model analysis concludes that H. pylori eradication in patients with duodenal ulcer disease is cost-effective in comparison to episodic therapy with omeprazole or maintenance therapy with ranitidine.
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Scand. J. Gastroenterol. Suppl. · Jan 1996
Comparative StudyHelicobacter pylori reinfection after apparent eradication--the Ipswich experience.
The reported rate of Helicobacter pylori reinfection following eradication therapy is highly variable. In Ipswich, the 14C-urea breath test (UBT) has been used since 1986 as a tool to study H. pylori eradication and reinfection. Updated results from 1182 patients in whom the organism had apparently been successfully eradicated, following a number of different eradication regimens between October 1986 and 31 March 1995, are presented. ⋯ Our data also suggest that the true reinfection rate is particularly low if the eradication therapy chosen has an efficacy of more than 85%. Several effective and well-tolerated 1-week triple H. pylori eradication regimens are now available, and we would advocate their use in preference to the less effective dual regimens where initial eradication rates are lower and there is consequently a higher risk of 'reinfection'. We would predict that even in developing countries with a high prevalence of metronidazole-resistant H. pylori, the 'reinfection' rate would be low if a combination of omeprazole, amoxycillin and clarithromycin were to be used.