Management of Helicobacter Pylori Infection and Effectiveness Rates in Daily Clinical Practice in Spain: 2010–2019
Abstract
:1. Introduction
IISCC2005[5] | IIISCC2013[6] | IVSCC2016[7] |
PCA 7–10 days | PCAM 10 days | PCAM 10–14 days PBMT 10 days |
Maastricht III2007[10] | Maastricht IV2012[11] | Maastricht V2016[12] |
PC A/M >7 days | PCA 10–14 days PBMT | PCAM 10–14 days PBMT 10–14 days |
2. Results
2.1. Baseline Characteristics
2.2. First-Line Prescription Trends
2.3. Effectiveness Analysis
2.3.1. First-Line Eradication Rates
2.3.2. Effectiveness Analysis Based on Other Variables
3. Discussion
3.1. PCA
3.2. PCAM
3.3. PBMT–PPYLERA®
3.4. PLA
3.5. Strengths and Weaknesses
4. Materials and Methods
4.1. Study Design
4.2. Variables
4.3. Definition of Agreement with Guidelines
- First triene (2010–August 2013, and 6 months after the III (third) Spanish Consensus Conference (SCC) publication): PCA (PPI + Clarithromycin + Amoxicillin);
- Second triene (February 2013–November 2016, and 6 months after the IV SCC publication): PCAM(PPI + Clarithromycin + Amoxicillin + Metronidazole);
- Third triene (May 2016–December 2019): PPylera ® (PPI + Pylera®, the three-in-one capsule containing Bismuth Subcitrate + Metronidazole + Tetracycline).
4.4. Statistical Analysis and Ethics Statement
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Categories | ITT | PP | ||||
---|---|---|---|---|---|---|---|
N | % | 95% CI | N | % | 95% CI | ||
Treatment | PCAM | 737 | 76.9% | 73.8–79.8 | 719 | 78,9% | 75.7–81.7 |
PCA | 686 | 63.4% | 59.7–66.9 | 676 | 64.3% | 60.7–67.9 | |
PLA | 123 | 69.1% | 60.5–76.6 | 120 | 70.8% | 62.2–78.2 | |
PPylera® | 87 | 81.6% | 72.2–88.4 | 87 | 81.6% | 72.2–88.4 | |
Other treatments | 11 | 36.4% | 15.2–64.6 | 9 | 44.4% | 18.9–73.3 | |
p-value | <0.001 | <0.001 | |||||
Duration | 7 days | 67 | 56.7% | 44.8–67.9 | 66 | 57.6% | 45.6–68.8 |
10 days | 612 | 72.9% | 69.2–76.2 | 598 | 74.6% | 70.9–77.9 | |
14 days | 333 | 82.3% | 77.8–86.0 | 329 | 83.3% | 78.9–86.9 | |
p-value | <0.001 | <0.001 | |||||
PPI | Omeprazole | 284 | 73.6% | 68.2–78.4 | 282 | 74.1% | 68.7–78.9 |
Esomeprazole | 101 | 82.2% | 73.6–88.4 | 101 | 82.2% | 73.6–88.4 | |
Other PPI | 61 | 70.5% | 58.1–80.4 | 61 | 70.5% | 58.1–80.4 | |
p-value | 0.154 | 0.169 | |||||
Sex | Female | 971 | 68.5% | 65.6–71.3 | 955 | 69.6% | 66.6–72.5 |
Male | 673 | 73.8% | 70.4–77.0 | 656 | 75.8% | 72.3–78.9 | |
p-value | 0.019 | 0.007 | |||||
Center | Center 1 (Z) | 766 | 70.5% | 67.2–73.6 | 744 | 72.6% | 69.3–75.7 |
Center 2 (T) | 878 | 70.8% | 67.8–73.8 | 867 | 71.7% | 68.7–74.6 | |
p-value | 0.878 | 0.708 | |||||
Age | <55 years | 962 | 69.6% | 66.7–72.5 | 938 | 71.4% | 68.5–74.2 |
≥55 years | 682 | 72.1% | 68.7–75.4 | 673 | 73.1% | 69.6–76.3 | |
p-value | 0.274 | 0.459 | |||||
Appropriateness | No | 388 | 65.7% | 60.9–70.3 | 381 | 66.9% | 62.1–71.5 |
Yes | 1256 | 72.2% | 69.7–74.6 | 1230 | 73.7% | 71.2–76.1 | |
p-value | 0.014 | 0.010 | |||||
Total | 1644 | 70.7% | 68.4–72.8 | 1611 | 72.1% | 69.9–74.3 |
Univariate | Multivariate | ||||
---|---|---|---|---|---|
OR (95% CI) | p-Value | OR (95% CI) | p-Value | ||
Treatment | [R: PCAM] | 1 | 1 | ||
PCA | 0.520 (0.412–0.655) | <0.001 | 0.489 (0.376–0.636) | <0.001 | |
PLA | 0.671 (0.441–1.020) | 0.062 | 0.595 (0.305–1.014) | 0.056 | |
PPylera® | 1.330 (0.753–2.350) | 0.325 | 1.266 (0.714–2.243) | 0.420 | |
Othertreatments | 0.171 (0.050–0.592) | 0.005 | 0.162 (0.05–0.587) | 0.006 | |
Duration | [R: 7 days] | 1 | - | - | |
10 days | 2.050 (1.225–3.432) | 0.006 | |||
14 days | 3.544 (2.026–6.200) | <0.001 | - | - | |
PPI | [R: Omeprazole] | 1 | |||
Esomeprazole | 1.655 (0.932–2.937) | 0.085 | - | - | |
Other PPI | 0.857 (0.466–1.578) | 0.621 | - | - | |
Sex | [R: Female] | 1 | 1 | ||
Male | 1.299 (1.044–1.617) | 0.021 | 1.270 (1.013–1.592) | 0.038 | |
Center | [R: Center 1 (Z)] | 1 | 1 | ||
Center 2 (T) | 1.017 (0.822–1.258) | 0.878 | 1.132 (0.902–1.419) | 0.284 | |
Age | [R: <55 years] | ||||
≥55 years | 1.129 (0.090–1.401) | 0.274 | 1.106 (0.885–1.383 | 0.374 | |
Appropriateness | [R: No] | 1 | 1 | ||
Yes | 1.355 (1.063–1.729) | 0.014 | 0.893 (0.645–1.236) | 0.493 |
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Ariño Pérez, I.; Martínez-Domínguez, S.J.; Alfaro Almajano, E.; Carrera-Lasfuentes, P.; Lanas, Á. Management of Helicobacter Pylori Infection and Effectiveness Rates in Daily Clinical Practice in Spain: 2010–2019. Antibiotics 2022, 11, 698. https://doi.org/10.3390/antibiotics11050698
Ariño Pérez I, Martínez-Domínguez SJ, Alfaro Almajano E, Carrera-Lasfuentes P, Lanas Á. Management of Helicobacter Pylori Infection and Effectiveness Rates in Daily Clinical Practice in Spain: 2010–2019. Antibiotics. 2022; 11(5):698. https://doi.org/10.3390/antibiotics11050698
Chicago/Turabian StyleAriño Pérez, Inés, Samuel J. Martínez-Domínguez, Enrique Alfaro Almajano, Patricia Carrera-Lasfuentes, and Ángel Lanas. 2022. "Management of Helicobacter Pylori Infection and Effectiveness Rates in Daily Clinical Practice in Spain: 2010–2019" Antibiotics 11, no. 5: 698. https://doi.org/10.3390/antibiotics11050698