Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. European Helicobacter Pylori Study Group.
Современные европейские концепции лечения инфекции Helicobacter pylori: Маастрихтский консенсусный доклад. Европейская исследовательская группа по Helicobacter pylori
1997-07-01
SCID: 54.1/rxp5m985
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13C urea breath testHelicobacter pylori eradicationMaastricht Consensus Reportpeptic ulcer diseaseproton pump inhibitor triple therapy
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Abstract (AI)
There is considerable confusion over the management of Helicobacter pylori infection, particularly among primary care physicians, and numerous European countries lack national guidelines in this rapidly growing area of medicine. The European Helicobacter Pylori Study Group therefore organised a meeting in Maastricht of H pylori experts, primary care physicians and representatives of National Societies of Gastroenterology from Europe to establish consensus guidelines on the management of H pylori at the primary care and specialist levels, and to consider general health care issues associated with the infection. As in previous guidelines, eradication therapy was recommended in all H pylori positive patients with peptic ulcer disease. Additionally, at the primary care level in dyspeptic patients < 45 years old and with no alarm symptoms, diagnosis is recommended by non-invasive means (13C urea breath test, serology) and if H pylori positive the patient should be treated. Moreover, at the specialist level the indications for eradication of H pylori were also broadened to include H pylori positive patients with functional dyspepsia in whom no other possible causes of symptoms are identified by the specialist (after a full investigation including endoscopy, ultrasound and other necessary investigations), patients with low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma (managed in specialised centres) and those with gastritis with severe macro- or microscopic abnormalities. There was consensus that treatment regimens should be simple, well tolerated and achieve an eradication rate of over 80% on an intention to treat basis. It was strongly recommended, therefore, that eradication treatment should be with proton pump inhibitor based triple therapy for seven days, using a proton pump inhibitor and two of the following: clarithromycin, a nitroimidazole (metronidazole or tinidazole) and amoxycillin.
Key Findings
1
Eradication therapy was recommended for all H. pylori-positive patients with peptic ulcer disease.
2
In dyspeptic patients younger than 45 years without alarm symptoms, non-invasive testing was recommended; H. pylori-positive patients should receive treatment.
3
Specialist-level eradication indications were broadened to selected functional dyspepsia, low-grade gastric MALT lymphoma, and severe gastritis cases after appropriate evaluation.
4
The Maastricht Consensus established European guidelines for managing Helicobacter pylori infection across primary care and specialist settings.
5
Treatment regimens should be simple, well tolerated, and achieve over 80% eradication on an intention-to-treat basis; recommended therapy was seven-day proton pump inhibitor-based triple therapy.
Research Object
Management of Helicobacter pylori infection in European primary care and specialist settings
Research Subject
Consensus-based indications and treatment strategies for H. pylori eradication, including patient selection, diagnostic approaches, and effective, tolerable eradication regimens
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1997-07-01
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