Helicobacter pylori eradication in the Swedish population

Doorakkers, Eva; Lagergren, Jesper; Gajulapuri, Vijaya Krishna; Callens, Steven; Engstrand, Lars; Brusselaers, Nele

doi:10.1080/00365521.2017.1303844

Title

Helicobacter pylori eradication in the Swedish population

Author

Doorakkers, Eva

Lagergren, Jesper

Gajulapuri, Vijaya Krishna

Callens, Steven

Engstrand, Lars

Brusselaers, Nele

Abstract

Objectives:Helicobacter pylori is associated with peptic ulcers and gastric cancer and its eradication aims to prevent these conditions. The recommended eradication regimen is triple therapy, consisting of a proton-pump inhibitor in combination with clarithromycin and amoxicillin or metronidazole for 7days. Yet, other antibiotic regimens are sometimes prescribed. We aimed to assess the use of eradication therapy for H. pylori in the Swedish population during the last decade.Materials and methods: This population-based study used data from the Swedish Prescribed Drug Register. From July 2005 until December 2014, all regimens that can eradicate H. pylori were identified and evaluated according to patients' age and sex and calendar year of eradication.Results: We identified 157,915 eradication episodes in 140,391 individuals (53.8% women, 42.6% older than 60years), who correspond to 1.5% of the Swedish population. The absolute number and incidence of eradications decreased over the study period. Overall, 91.0% had one eradication and 0.1% had more than three. Of all eradications, 95.4% followed the recommended regimen, while 4.7% did not. The latter group was overrepresented among individuals aged 80years (7.8%). Amoxicillin and clarithromycin were most frequently prescribed, while metronidazole was rarely used (0.01%). Other prescribed antibiotics were ciprofloxacin (2.4%), doxycycline (1.4%), nitrofurantoin (0.7%), norfloxacin (0.5%) and erythromycin (0.3%).Conclusions: During the last decade in Sweden H. pylori eradication has been frequently prescribed, but the incidence of eradication has slowly declined. Most eradications followed the recommended regimen, including those occurring after a previous eradication.

Language

English

Source (journal)

Scandinavian journal of gastroenterology. - Oslo

Publication

Oslo : 2017

ISSN

0036-5521

DOI

10.1080/00365521.2017.1303844

Volume/pages

52 :6-7 (2017) , p. 678-685