title: Hp-normogram (normo-graham) for Assessing the Outcome of H. pylori Therapy: Effect of Resistance, Duration, and CYP2C19 Genotype.
abstract: There have been hundreds of H. pylori eradication trials and yet doubt remains regarding the best regimen for any situation. With most regimens, treatment failure is the result of resistance to one component (e.g., clarithromycin). Thus, if one knows the treatment success with two groups (all with susceptible and with all with resistant infections), one can construct a normogram that provides a reliable estimate of the outcome at any prevalence of resistance. The same data can be used to estimate the prevalence of resistance in any clinical trial, the effects duration of therapy, and effects of any procedures to improve outcome (e.g., increasing the proton-pump inhibitor dose, the duration of therapy, etc.). Because the Hp-normo-graham can reliably predict the outcome of clinical trials, it can also obviate the need for many clinical trials in populations where resistance is common. Here, we illustrate the construction of Hp-normo-graham and its use to describe the effects of resistance, duration of therapy, attempts to improve results, and the prevalence of resistance and to obviate the need for many clinical trials.
authors.affiliation: Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Houston, Houston, TX, USA.
authors.forename: David Y
authors.initials: DY
authors.lastname: Graham
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics*; D024881:Drug Resistance, Bacterial; D005838:Genotype; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D065731:Cytochrome P-450 CYP2C19
keywords: Helicobacter pylori; Normogram; antibiotic resistance; antibiotic therapy; duration