urea breath tests for detecting Helicobacter pylori

Abstract

The urea breath test (UBT) is the most sensitive and specific non‐invasive test for the detection of Helicobacter pylori infection both before and after treatment. Labelling of the urea with either 13C or 14C has relative advantages and disadvantages. 13C‐UBTs are both safe and well‐validated, and have the additional advantage that they can be used in children. However, the initial capital costs of 13CO2 analysis are large compared to those for 14CO2. The protocol details for use of the 13C‐UBT are variable: a test meal is important if urea solution is to be used and a single sample time point at 30 min is adequate. The recent development of novel formulations of 13C urea and new analytical techniques for the measurement of 13CO2 should allow reduction in the length of the test and its cost; they may herald a more widespread clinical application of this useful test.

High levels of dual resistance to clarithromycin and metronidazole and in vitro activity of levofloxacin against Helicobacter pylori isolates from patients after failure of therapy

“…All of the infections had originally been diagnosed based on the 13 C-urea breath test, performed according to the European Standard Protocol [29], and treatment was administered empirically. When symptoms continued after the first course of therapy, the persistence of infection was confirmed with a repeat breath test, and the second course of therapy was prescribed.…”

Refinement of the 14C-urea Breath Test for Detection of Helicobacter pylori

“…UBT is considered easy to perform, without discomfort and carries minimal radiation risk, especially with 1.0 mCi of 14 C-urea, which equals the background radiation a person is exposed to in a day (11). With the use of this low radiation dose, even permitted for use in children, the UBT has shown a reliable accuracy (12).…”

Helicobacter pylori: Optimum Diagnosis and Test of Cure

“…The use of a less than optimal protocol is certainly the principal cause of inaccuracy of the 13 C-UBT. Furthermore, all the drugs which are active against H. pylori in vivo, such as antibiotics, bismuth compounds, PPI or anti-H2 can reduce the sensitivity of the test since they suppress H. pylori, thus producing false-negative results 27 and must be suspended for at least 2 weeks before administering the 13 C-UBT 28 . If, however, the patient undergoes antibiotic therapy, 13 C-UBT must not be started until 4 weeks after the end of the therapy 28 .…”