[Helicobacter pylori infection. The Spanish consensus report. The Spanish Consensus Conference Group].
OBJECTIVE
taking into account the small amount of infection eradication treatments carried out in our country and some characteristics arising from the resistances to some antibiotics, the Spanish Club for the Study of Helicobacter pylori decided to organize a Spanish Consensus Conference to clarify the use of the different infection diagnostic tests, to establish the exact indications of its diagnosis and treatment, to recommend the best treatment guidelines for our country and to promote the use of eradication treatments in adequate indications.


METHODS
on April 23, 1999 in Madrid, physicians who were experts in infection by Helicobacter pylori representing the different Scientific Societies of our country were gathered. Prior to this, three work areas, diagnosis, indications and treatments, were created and the participants freely joined them. One month before the conference, all of the participants were sent the questions which would be debated. An 80% consensus level, always based on scientific evidence, was required for a recommendation. In the first session, a meeting by work areas was held and in a second session, all of the recommendations were voted on in the meeting of the representatives.


CONCLUSIONS
the conference recommends the eradication of the infection in all the gastric or duodenal ulcers, in the erosive duodenitis, in the MALT lymphomas and in gastrectomized patients due to gastric cancer with residual stomach. In the de novo diagnoses of gastroduodenal ulcer, the rapid test of urease is recommended, and a histological study is recommended only if it is negative. In the case of a history of ulcers and also to know the eradication treatment result, the C13 urea breath test is recommended. The culture is reserved for primary treatment and rescue treatment failures so as to select the adequate antibiotic. The primary treatment regimes recommended for our country mean the combination of amoxicillin, clarithromycin and any proton pump inhibitor or with Ranitidine bismuth citrate. If there is allergy to penicillin, amoxycillin will be substituted by metronidazol.
Sainz
R
R
Servicio de Aparato Digestivo, Hospital Clínico, Zaragoza, España.
Borda
F
F
Domínguez
E
E
Gisbert
J P
JP
D000658:Amoxicillin / Q000627:therapeutic use; D000863:Antacids / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000188:drug therapy; D004382:Duodenitis / Q000188:drug therapy; D005743:Gastrectomy; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy; D009942:Organometallic Compounds / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D011899:Ranitidine / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000601:surgery; D013276:Stomach Ulcer / Q000188:drug therapy
D000863:Antacids; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D009942:Organometallic Compounds; D010406:Penicillins; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D011899:Ranitidine; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate; D001729:Bismuth
Conferencia Española de Consenso sobre la infección por Helicobacter pylori.