TBA (22W146)

An Audit of First-Line H. pylori Treatments and Outcomes from 2019-2021 in Tallaght University Hospital

Author(s)

R. FitzGerald (1), T. Butler (1), M. Gregg (2), L. Dooley (3), C. Flynn (3), A. Al Wahshi (1), C. Tan (1), D. McNamara (1,2), S.M. Smith (1).

Department(s)/Institutions

1. School of Medicine, Trinity College Dublin, Dublin, Ireland; 2. Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland; 3. School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.

Introduction

Regular local evaluation of H. pylori eradication rates is recommended to determine the most appropriate treatment.

Aims/Background

Determine first-line treatments and eradication rates for H. pylori in Tallaght University Hospital.

Method

Post-eradication therapy 13C-urea breath test data were retrospectively collected from the Synergy database and analysed using Microsoft Excel

Results

In total, data from 294 patients were analysed. 89 patients were included from 2019 (37.1% male; mean age 53±16 years). 91% were treated with clarithromycin triple therapy (CTT), 3.4% with metronidazole triple therapy (MTT), 4.5% with levofloxacin triple therapy (LTT) and 1.1% with bismuth quadruple therapy (BQT). The overall eradication rate was 78.6% and the eradication rate for CTT was 82.7%. The numbers of other treatments were too small to calculate meaningful eradication rates. Only 39 patients were included in 2020 (38.5% male, mean age 44.8±15 years) due to the Covid19 pandemic. In 97.4% of cases patients were treated with CTT and 2.6% were treated with BQT. The overall eradication rate was 82.5% and 81.6% for CTT. In 2021 there were 166 patients included (53.6% male; mean age 51.2±15 years). 93.9% were treated with CTT, 1.2% with LTT, 4.2% with MTT and 0.6% were treated with BQT. The overall eradication rate was 81.9%. For CTT the eradication rate was 82.6%.

Conclusions

Although the eradication rate for the most commonly prescribed CTT remained stable over time, it falls short of the recommended eradication rate. Alternative first-line treatment regimens or susceptibility testing should be considered to improve eradication.