First-line eradication therapy for Helicobacter pylori in primary health care based on antibiotic resistance: results of three eradication regimens

2005 ◽  
Vol 21 (6) ◽  
pp. 773-782 ◽  
Author(s):  
T. T. Koivisto ◽  
H. I. Rautelin ◽  
M. E. Voutilainen ◽  
M. T. Heikkinen ◽  
J. P. Koskenpato ◽  
...  
Keyword(s):  
Health Care ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Primary Health Care ◽  
Eradication Therapy ◽  
First Line ◽  
Primary Health

Antibiotics Prescription Patterns in Primary Health Care in Qatar – A Population based study from 2017 to 2018

2020 ◽  
Author(s):  
Hanan Khudadad ◽  
Lukman Thalib
Keyword(s):  
Health Care ◽  
Antibiotic Resistance ◽  
Primary Health Care ◽  
Respiratory System ◽  
Population Based ◽  
Antibiotics Resistance ◽  
Prescription Patterns ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Background: Antibiotics are antimicrobial drugs used in the treatment and prevention of bacterial infections. They played a pivotal role in achieving major advances in medicine and surgery (1). Yet, due to increased and inappropriate use of antibiotics, antibiotic resistance (AR) has become a growing public health problem. Information on antibiotic prescription patterns are vital in developing a constructive approach to deal with growing antibiotic resistance (2). The study aims to describe the population based antibiotic prescriptions among patients attending primary care centers in Qatar. Methodology: A population based observational study of all medications prescribed in the all Primary Health Care Centers during the period of 2017-2018 in Qatar. Records with all medication prescriptions were extracted and linked to medical diagnosis. Antibiotics prescriptions records were compared to non- antibiotics records using logistic regression model in identifying the potential predictors for antibiotic prescriptions. Results: A total of 11,069,439 medication prescriptions given over a period of two-years, we found about 12.1% (n= 726,667) antibiotics prescriptions were antibiotics, and 65% of antibiotics are prescribed and received by the patients at the first visits. Paracetamol (22.3%) was the first highest medication prescribed followed by antibiotics (12.1 %) and vitamin D2 (10.2 %). More than half of all antibiotics prescribed during the period of January 2017 to December 2018 were Penicillin (56.9%). We found that half of the antibiotics (49.3 %) have been prescribed for the respiratory system comparing to the other body system. We found that males were 29% more likely be given an antibiotic compared to females (OR=1.29, 95% CI= 1.24- 1.33). Implications: The study provides a baseline data to enable PHCC management to design effective intervention program to address the problem of antibiotics resistance. Furthermore, it will help the policymakers to comprehend the size of the issue and develop a system to manage the antibiotics therapy. Conclusion: Antibiotics was the second highest medication prescribed in the Primary Health Care Centers in Qatar after paracetamol and most of the patients received it at the first visit. Most of the prescriptions in Primary Health Care Centers in Qatar were for the respiratory system, and Penicillin was the highest class prescribed. Male visitors were prescribed antibiotics more than female visitors.

Adherence To Lifestyle Modifications As A First-Line Therapy In Hypertension Management In Primary Health Care Setting, Medina, Saudi Arabia

2021 ◽  
Vol 9 (4) ◽  
pp. 1
Author(s):  
Abdulhadi Almadani ◽  
Abdulhameed Kashkari ◽  
Mohammed Almutairi ◽  
Mahmoud Alshanqiti ◽  
Obaid Aljarbou ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Primary Health Care ◽  
Care Setting ◽  
Hypertension Management ◽  
Lifestyle Modifications ◽  
First Line ◽  
First Line Therapy ◽  
Primary Health ◽  
Line Therapy

scholarly journals ANTIBIOTIC RESISTANCE SURVEILLANCE OF HELICOBACTER PYLORI AT THE BIOBÍO REGION (CHILE) IN A DECADE

2019 ◽  
Vol 56 (4) ◽  
pp. 361-366
Author(s):  
Cristian PARRA-SEPÚLVEDA ◽  
José S MERINO ◽  
Katia SÁEZ-CARRILLO ◽  
Carlos GONZÁLEZ ◽  
Apolinaria GARCÍA-CANCINO
Keyword(s):  
Health Care ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Blood Cells ◽  
Eradication Therapy ◽  
Clarithromycin Resistance ◽  
Resistant Strains ◽  
H Pylori ◽  
Horse Red Blood Cells ◽  
Co2 Atmosphere

ABSTRACT BACKGROUND: Helicobacter pylori infection in Chile remains as a public and private health-care system’s challenge, with a prevalence of the infection over 70%. Nowadays, antibiotic treatment of the infection is mandatory to prevent the arising of severe associated diseases but failures in the eradication therapy mainly due to clarithromycin resistance has been observed worldwide and first line eradication therapy seems to be not effective anymore in several geographical areas. Thus, health-care systems are committed to maintain an epidemiological surveillance upon the evolution of the antibiotic resistance of this priority 2 pathogen. OBJECTIVE: This work reports a 10 years surveillance of the primary antibiotic resistance of H. pylori clinical isolates at the Biobío region-Chile, and the evolution of resistance toward amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline among the species. METHODS: H. pylori strains were investigated during the periods 2005-2007 (1435 patients analysed) and 2015-2017 (220 patients analysed) by inoculating a saline homogenate biopsy onto the surface of Columbia agar (Oxoid, Basingstoke, UK) - supplemented with 7% horse red blood cells plus DENT inhibitor (Oxoid, Basingstoke, UK) - following by incubation at 37ºC under 10% CO2 atmosphere for five days. Antibiotic resistance pattern of the isolates was assessed using the disk diffusion test in Müeller-Hinton agar supplemented with 7% horse red blood cells followed by incubation for further three days under 10% CO2 atmosphere. Statistical analysis was done using the SPSS v22 software and P values <0.05 were considered statistically significant. RESULTS: A total of 41% of 1435 patients were detected to be infected with H. pylori by bacteriological culture in 2005-2007 period, meanwhile 32.7% from 220 patients were also infected in 2015-2017 period. The clinical isolates of H. pylori are mostly susceptible to amoxicillin and tetracycline (both over 98% of strains), but less susceptible to levofloxacin in both periods analysed (over 79% of the strains). On the other hand, metronidazole continuous showing the highest score of resistant isolates (over 40% of resistant strains), although an 18% fewer resistant strains were observed in 2015-2017 period. Clarithromycin, the key antibiotic in eradication therapies, has an increased frequency of resistant strain isolated in the decade (22.5% in 2005-2007 and 29.2% in 2015-2017). Multidrug resistant strains (two, three and four antibiotics) were also detected in both periods with the highest scores for simultaneous resistance to clarithromycin-metronidazole (18%) and clarithromycin-metronidazole-levofloxacin (12.5%) resistant strains. According to gender, the isolates resistant to amoxicillin, clarithromycin and metronidazole were more frequent in female, with a specific increment in amoxicillin and clarithromycin resistance. CONCLUSION: The frequency of clarithromycin resistance (29.2%) detected in 2015-2017 suggests that conventional triple therapy is no longer effective in this region.

scholarly journals Effectiveness of Trainings of General Practitioners on Antibiotic Stewardship: Methods of a Pragmatic Quasi-Experimental Study in a Controlled Before-After Design in South-East-Lower Saxony, Germany (WASA)

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniela Gornyk ◽  
Martina Scharlach ◽  
Brigitte Buhr-Riehm ◽  
Carolina Judith Klett-Tammen ◽  
Sveja Eberhard ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Antibiotic Resistance ◽  
Primary Health Care ◽  
Data Protection ◽  
Control Group ◽  
Lower Saxony ◽  
Primary Health ◽  
Antibiotic Management ◽  
Quasi Experimental

Introduction: Antibiotic resistance is a serious threat to global public health. It reduces the effectiveness of treatments for serious bacterial infections and thus increases the risk of fatal outcomes. Antibiotic prescriptions are often not in line with clinical evidence-based guidelines. The process of emergence of resistant bacteria can be slowed down by adherence to guidelines. Yet this adherence seems to be lacking in primary health care.Methods and Analysis: This pragmatic quasi-experimental study using a controlled before-after design was carried out in South-East-Lower Saxony in 2018–2020. The voluntary attendance of interactive trainings with condensed presentation of current guidelines for general practitioners (GP) on antibiotic management for urinary and respiratory tract infections is regarded as intervention. Those GP not attending the trainings constitute the control group. Data were collected via questionnaires; routine health records are provided by a statutory health insurance. The primary outcome is the proportion of (guideline-based) prescriptions in relation to the relevant ICD-10 codes as well as daily defined doses and the difference in proportion of certain prescriptions according to guidelines before and after the intervention as compared to the control group. Further outcomes are among others the subjectively perceived risk of antibiotic resistance and the attitude toward the guidelines. The questionnaires to assess this are based on theory of planned behavior (TPB) and health action process approach (HAPA). Variations over time and effects caused by measures other than WASA (Wirksamkeit von Antibiotika-Schulungen in der niedergelassenen Aerzteschaft-Effectiveness of antibiotic management training in the primary health care sector) training are taken into account by including the control group and applying interrupted time series analysis.Ethics and Dissemination: The study protocol and the data protection concept respectively were reviewed and approved by the Ethics Committee of the Hannover Medical School and the Federal Commissioner for Data Protection and Freedom of Information.Trial Registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&amp;TRIAL_ID=DRKS00013951, identifier DRKS00013951.

scholarly journals Consensus Guidelines: Agreement and Debate Surrounding the Optimal Management ofHelicobacter pyloriInfection

2000 ◽  
Vol 14 (6) ◽  
pp. 511-517 ◽  
Author(s):  
D McNamara ◽  
C O’Morain
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Eradication Therapy ◽  
Public Health Care ◽  
Consensus Guidelines ◽  
Care Issue ◽  
Primary Health ◽  
H Pylori

Helicobacter pyloriis a recognized cause of a variety of gastroduodenal pathology. The high prevalence of bothH pyloriinfection and related diseases within the community warrants its consideration as a public health care issue. The availability of reliable and safe noninvasive diagnostic techniques coupled with the development of effective and tolerable treatments has enabled primary health care personnel to manage this infection actively. The role of the primary care physician in the future management ofH pyloriinfection is thus of central importance. The wealth of evidence produced by over 15 years of research intoH pylorihas expanded the list of disease associations and treatment benefits as well as elucidated the pathophysiological mechanisms involved. As a result, there has been a growing need to harmonize this information with clinical practice and to provide direction for the appropriate management by both specialists and general practitioners. Several national guidelines have been produced. The areas relating toH pyloriinfection that they considered and their recommendations vary. In 1994, the National Institutes of Health produced globally accepted recommendations for the management ofH pylori-related peptic ulceration. The broader role ofH pylorias a gastroduodenal pathogen and a public health care issue was not addressed. Recently, European and Canadian consensus guidelines have been published that identified overall management issues, including the role of primary and specialist care, and considered the appropriateness of employing eradication therapy for the spectrum of conditions in whichH pylorihas a direct or indirect association based on the available information. These guidelines, while in agreement regarding many issues, differ considerably in their recommendations for primary health care and regarding central issues such as the management of dyspepsia and gastric cancer. Some variations may reflect differing health care structures as well as the prevalence of both infection and associated diseases. However, the interpretation of evidence produced by recent research contributes to their conflicting statements.

Sign in / Sign up

Export Citation Format

Share Document