V Spanish Consensus Conference on Helicobacter pylori infection treatment

Gisbert, Javier P.; Alcedo, Javier; Amador, Javier; Bujanda, Luís; Calvet, Xavier; Castro‐Fernández, Manuel; Fernández-Salazar, Luis; Gené, Emili; Lanas, Fernando; Lucendo, Alfredo J.; Molina–Infante, Javier; Nyssen, Olga P.; Pérez-Aísa, Ángeles; Puig, Ignasi

doi:10.1016/j.gastre.2021.07.001

Cited by 13 publications

(39 citation statements)

References 229 publications

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“…Today, in many countries, H. pylori infection is mainly managed by PCPs instead of gastroenterologists [ 17 , 18 ]. It is important to know the management of H. pylori infection by PCPs, as it allows us to develop strategies to improve the diagnosis and treatment of the infection based on current national and international guidelines and consensus documents [ 8 , 9 , 19 , 20 ]. Proper management has a significant impact on healthcare systems, since overdiagnosis and inadequate antibiotic treatment can lead to an increase in global antibiotic resistance.…”

Section: Discussionmentioning

confidence: 99%

“…Current guidelines do not support testing or treating H. pylori infection in patients with gastroesophageal reflux symptoms. Moreover, dyspepsia in patients older than 55 years involves performing an upper gastrointestinal endoscopy as the first medical exam because the risk of gastric cancer increases from that age, according to national guidelines [ 9 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Different Strategies to Improve the Management of Helicobacter pylori Infection at the Primary Care Level: Training Sessions Increase Prescription Appropriateness of Treatment Regimens

et al. 2022

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Helicobacter pylori infection (H. pylori) is mainly managed at the primary care level. Our group previously performed a study demonstrating that providing specific counselling (SC) to primary care practitioners (PCPs) who requested a urea breath test (UBT) improved treatment management but not indications for H. pylori tests. SC was given in the form of a personal letter addressed to PCPs with UBT results which contained information about accepted UBT indications and a Helicobacter pylori treatment algorithm. The purpose of the present study was to evaluate the effect of training sessions (TS) on UBT indications, antibiotic prescriptions and eradication rates. This was a quasi-experimental study performed at primary care centres (PCCs). Phase I included 399 patients diagnosed with H. pylori infection after providing SC to PCPs. Phase II included 400 H. pylori-positive patients after giving TS to PCPs who had already received SC (100 from PCCs with TS and 300 from PCCs without TS). An improved trend in the appropriate indication of H. pylori diagnosis was observed between Phase I and PCCs with TS in Phase II (57.5% vs. 67%; p = 0.06). TS improved appropriate prescriptions in PCCs with TS compared to PCCs that only received SC in Phase I and II (94% vs. 75.3%, p = 0.01; 94% vs. 85.6%, p = 0.04, respectively). Eradication rates showed no differences between groups. In conclusion, training sessions after specific counselling improved antibiotic prescription appropriateness but not eradication rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of Different Strategies to Improve the Management of Helicobacter pylori Infection at the Primary Care Level: Training Sessions Increase Prescription Appropriateness of Treatment Regimens

et al. 2022

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“…Thus, the benefits of this strategy in all scenarios should not be entirely assumed, especially for high-tech less invasive tests that require intense manufacturing and processing. Until further data are available, ESGE-ESGENA encourage less invasive tests for the indications endorsed by evidence-based clinical guidelines (▶ Table 4 [48][49][50][51][52][53][54][55][56]).…”

Section: Statementmentioning

confidence: 99%

Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Dinis‐Ribeiro²,

et al. 2022

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Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. This Position Statement aims to raise awareness of the ecological footprint of GI endoscopy and provides guidance to reduce its environmental impact. The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) outline suggestions and recommendations for health care providers, patients, governments, and industry. Main statements 1 GI endoscopy is a resource-intensive activity with a significant yet poorly assessed environmental impact. 2 ESGE-ESGENA recommend adopting immediate actions to reduce the environmental impact of GI endoscopy. 3 ESGE-ESGENA recommend adherence to guidelines and implementation of audit strategies on the appropriateness of GI endoscopy to avoid the environmental impact of unnecessary procedures. 4 ESGE-ESGENA recommend the embedding of reduce, reuse, and recycle programs in the GI endoscopy unit. 5 ESGE-ESGENA suggest that there is an urgent need to reassess and reduce the environmental and economic impact of single-use GI endoscopic devices. 6 ESGE-ESGENA suggest against routine use of single-use GI endoscopes. However, their use could be considered in highly selected patients on a case-by-case basis. 7 ESGE-ESGENA recommend inclusion of sustainability in the training curricula of GI endoscopy and as a quality domain. 8 ESGE-ESGENA recommend conducting high quality research to quantify and minimize the environmental impact of GI endoscopy. 9 ESGE-ESGENA recommend that GI endoscopy companies assess, disclose, and audit the environmental impact of their value chain. 10 ESGE-ESGENA recommend that GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050.

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“…These methods can be based either on polyclonal or monoclonal antibodies [ 6 , 16 ]. With regard to “rapid” or “in-office” tests, controversial results have been reported [ 19 ] and they are not recommended in clinical practice guidelines due to their limited accuracy [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, a clinical review by the Canadian Drug Agency described a sensitivity and specificity of 90.0–92.4% and 91.0–100%, respectively, with monoclonal SAT [ 22 ]. Therefore, SAT is currently recommended by the main international guidelines as a valid and reliable diagnostic method [ 2 , 20 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a New Monoclonal Chemiluminescent Immunoassay Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: A Spanish Multicentre Study

Resina

Donday

Martínez

et al. 2022

JCM

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The stool antigen test (SAT) represents an attractive alternative for detection of Helicobacter pylori. The aim of this study was to assess the accuracy of a new SAT, the automated LIAISON® Meridian H. pylori SA based on monoclonal antibodies, compared to the defined gold standard 13C-urea breath test (UBT). This prospective multicentre study (nine Spanish centres) enrolled patients ≥18 years of age with clinical indication to perform UBT for the initial diagnosis and for confirmation of bacterial eradication. Two UBT methods were used: mass spectrometry (MS) including citric acid (CA) or infrared spectrophotometry (IRS) without CA. Overall, 307 patients (145 naïve, 162 with confirmation of eradication) were analysed. Using recommended cut-off values (negative SAT < 0.90, positive ≥ 1.10) the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 67%, 97%, 86%, 92% and 91%, respectively, obtaining an area under the receiver operating characteristic (ROC) curve (AUC) of 0.85. Twenty-eight patients, including seven false positives and 21 false negatives, presented a discordant result between SAT and UBT. Among the 21 false negatives, four of six tested with MS and 11 of 15 tested with IRS presented a borderline UBT delta value. In 25 discordant samples, PCR targeting H. pylori DNA was performed to re-assess positivity and SAT accuracy was re-analysed: sensitivity, specificity, positive predictive value, negative predictive value, accuracy and AUC were 94%, 97%, 86%, 99%, 97% and 0.96, respectively. The new LIAISON® Meridian H. pylori SA SAT showed a good accuracy for diagnosis of H. pylori infection.

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V Spanish Consensus Conference on Helicobacter pylori infection treatment

Cited by 13 publications

References 229 publications

Evaluation of Different Strategies to Improve the Management of Helicobacter pylori Infection at the Primary Care Level: Training Sessions Increase Prescription Appropriateness of Treatment Regimens

Evaluation of Different Strategies to Improve the Management of Helicobacter pylori Infection at the Primary Care Level: Training Sessions Increase Prescription Appropriateness of Treatment Regimens

Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Evaluation of a New Monoclonal Chemiluminescent Immunoassay Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: A Spanish Multicentre Study

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