Multidisciplinary approach improves eradication rate and safety in refractory Helicobacter pylori infection: Multidisciplinary approach for H. pylori.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2024-12-18 DOI:10.14309/ctg.0000000000000804

Na Dai, Yu-Qin Zhao, Wen-Juan Wu, Zheng-Lin Shen, Yan-Hua Xu, Xiao-Yang Wu, Gui-Zhen Zhang, Lan Wang, Qing-Hua Wang

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引用次数: 0

Abstract

Introduction: Helicobacter pylori (HP) infection is prevalent worldwide and contributes to various gastrointestinal diseases. Eradication therapy is crucial in managing HP infection, but antibiotic resistance has led to refractory cases, complicating treatment outcomes and increasing the risk of adverse events.

Objectives: This study aimed to evaluate the effectiveness of a multidisciplinary approach, termed HP Multidisciplinary Team (MDT) Clinic, in improving eradication rates and safety in patients with refractory HP infection.

Methods: Between November 2020 and November 2023, 153 patients with refractory HP infection were included, with 51 patients in the non-HP-MDT group and 102 patients in the HP-MDT group. The HP-MDT clinic provided personalized treatment plans, patient education, and follow-up. Genetic testing was conducted in selected cases to assess resistance patterns.

Results: Patients attending the HP-MDT clinic showed significantly higher eradication rates compared to those in the non-HP-MDT group (80.39% vs. 50.98%, P<0.001). Logistic regression analysis confirmed that HP-MDT clinic attendance was independently associated with higher eradication rates (OR: 4.43, 95% CI: 2.02 to 9.71, P<0.001). Genetic testing revealed high rates of antibiotic resistance, particularly to clarithromycin (10/11, 90.91%) and metronidazole (11/11, 100%). Despite resistance, the HP-MDT approach achieved a high eradication rate of 92.31%. Adverse drug reactions occurred in 12.75% of patients in the HP-MDT group, predominantly mild gastrointestinal symptoms.

Conclusion: The HP-MDT Clinic, integrating medical, pharmaceutical, and nursing expertise, significantly improved eradication rates and safety in patients with refractory HP infection. Personalized treatment plans, patient education, and genetic testing contributed to successful outcomes with minimal adverse events.

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.