Eradication treatment for Helicobacter pylori in general practice.
OBJECTIVE
To identify patients with a past history of peptic ulcer and to treat Helicobacter pylori infection if confirmed.


METHODS
Patient records from 6.5 full-time equivalent general practitioners were reviewed to record prescribing of H2-receptor antagonists in the last year and to review previous upper gastrointestinal investigations.


RESULTS
Two hundred and sixty-seven patients had used H2-receptor antagonists in the previous year. The indications for use were peptic ulcer 25%, reflux 21%, empiric treatment for dyspepsia 39% and dyspepsia with a normal investigation 15%. Short-term prescribing was common (52% of patients treated for 1-2 months only) and of these patients 50% had undiagnosed dyspepsia. The most common indication for long-term prescribing (6 months or more) was peptic ulcer (46%). The records of 96 patients with peptic ulcer were identified; 50 were traced and considered for recall and a 13C urea breath test for Helicobacter pylori. Thirty-eight patients agreed to a breath test; 23 were positive (60.5%). Follow up breath test was negative following eradication treatment in 16 of 22 treated patients (73%).


CONCLUSIONS
Patients with peptic ulcer disease can be recalled using general practice case notes and treated with antibiotic treatment. The majority of H2-receptor antagonist use is for indications other than peptic ulcer disease.
Fraser
A G
AG
Department of Medicine, Faculty of Medicine and Health Sciences, University of Auckland.
Moore
L
L
Berry
S
S
Arroll
B
B
D000368:Aged; D001944:Breath Tests; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology; D005194:Family Practice; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology
D006635:Histamine H2 Antagonists