In your message dated Monday 15, July 1996 Hotch wrote :
> Anyone close to the data on H Pylori cure rates?
>
> Drug company brochures seem to have cure rates in the high 90s.
>
> My personal success rate, having prescribed eradication regimes to
> about 50 people in the last year is about 0% They all end up going
> back on maintenance therapy. Or seem to. I'm not auditing this - on
> principle.
>
> I say to patients: look, the hospital suggests you try this regime
> for a couple of weeks. It *might* cure you, but it might not. It's
> worth a try. However, it seems to be getting less and less *worth*
> it.
>
> Is anyone getting 'good' results with their eradication therapy???
Oh my God! A heartsink doctor! Hotch, if you sit in front of your
patients looking miserable and burnt out (at 16 - desperate) and
intimate that this treatment from the hospital which involves taking
lots of pills and staying off the booze for a week or two isn't much
cop, then they'll take the hint and not bother to take the treatment.
So it won't work. Even staring-eyed fanatics like me have difficulty
in persuading patients that they have to take the whole course and not
stop it when the omeprazole or whatever relieves their pain.
The May/June 1996 edition of Evidence-Based Medicine has an abstract
of an RCT of Amoxycillin 1g bd/Omeprazole 1g bd for a fortnight vs
Omeprazole 20mg bd/colloidal bismuth subcitrate 120mg qds/tetracycline
500mg qds/metronidazole 500mg tds (all for a week except the
omeprazole which was for ten days and started 3 days earlier.
Eradication rates were respectively 56% and 93% (p<0.001). Mind, this
was in Holland, and I can see certain problems in persuading some of
my Geordie patients to take all that stuff and stay off the Broon for
a week (actually, most of them drink lager these days or various other
even more disgusting drinks). Maybe the answer in my case would be to
restrict helicobacter eradication to outside the football season.
Toby
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| Dr Toby Lipman EMail [log in to unmask]
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| 7, Collingwood Terrace, Jesmond, Newcastle upon Tyne, NE2 2JP
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