Now that the Food and Drug Administration is examining various treatment regimens for eradication of Helicobacter pylori (H. pylori) infection, the question of whom to treat has come to the forefront.
Widespread attempts to eradicate the bacterium are not without risk, including the possibility of accelerating the emergence of resistant strains of the organism, in addition to possible adverse events of agents used to cure the infection.
These risks are of concern to the Agency in the process of granting marketing approvals for various therapies.
The association of H. pylori and duodenal ulcer (DU) is no longer disputed ; however, data to date have been generated in studies of patients with active (acute) DU.
In these patients, the benefits of eradication therapy are clear.
Patients with a documented history of DU who do not have an ulcer crater at the time of presentation have not been well studied in controlled trials.
If they are at similar risk for recurrence and complications, it follows that they, too, should be candidates for H. pylori testing and treatment.
However, if, as some believe, duodenal ulcer disease becomes « inactive » or « burns out » with time, an argument could be made for expectant treatment for this subgroup of patients.
The present review examines the available literature on the natural history of DU disease and explores the validity of the hypothesis of duodenal ulcer burn out. (...)
Mots-clés Pascal : Ulcère, Duodénum, Incidence, Guérison, Spontané, Effet biologique, Entérite, Campylobactériose, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Stratégie, Traitement, Etude statistique, Revue bibliographique, Homme, Appareil digestif pathologie, Intestin pathologie
Mots-clés Pascal anglais : Ulcer, Duodenum, Incidence, Cure, Spontaneous, Biological effect, Enteritis, Campylobacter infection, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Strategy, Treatment, Statistical study, Bibliographic review, Human, Digestive diseases, Intestinal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0220251
Code Inist : 002B13B03. Création : 21/05/1997.