For what conditions is there evidence-based justification for treatment of Helicobacter pylori infection ?
American Digestive Health Foundation International Update Conference on Helicobacter pylori. McLean, VA, USA, 1997/02/13.
Evidence-based medicine combines clinical expertise and the best available evidence from systematic research to aid decision making in patient care.
Levels of evidence can be graded from I to V, with level I, the strongest, coming from large randomized controlled trials (RCTs).
When a definitive RCT has not been performed, or is impracticable or inappropriate, lesser grades of evidence are used.
There is level I evidence supporting the treatment of Helicobacter pylori infection in patients with duodenal or gastric ulcers.
Prospective RCTs have shown that cure of the infection is associated with ultimate cure of the ulcer diathesis.
Therefore, this is a « grade A » recommendation for treatment.
In nonulcer dyspepsia, numerous RCTs have yielded conflicting results regarding the benefits of treatment.
Although there are methodological problems with many reported studies, there is some evidence (level II at best) to support treatment-a grade B recommendation.
In early gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma, the best available evidence supporting treatment of H. pylori infection is of low quality, i.e., levels III and V. Although these carry only grade C treatment recommendations, treatment is safe and carries at least some evidence of efficacy.
It is therefore indicated based on the current best available evidence. (...)
Mots-clés Pascal : Gastrite, Campylobactériose, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Indication, Traitement, Ulcère, Gastroduodénal, Hémorragie, Lymphome MALT, Carcinome, Estomac, Dyspepsie, Etude statistique, Homme, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Hémopathie maligne, Lymphoprolifératif syndrome, Lymphome non hodgkinien, Tumeur maligne
Mots-clés Pascal anglais : Gastritis, Campylobacter infection, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Indication, Treatment, Ulcer, Gastroduodenal, Hemorrhage, MALT lymphoma, Carcinoma, Stomach, Dyspepsia, Statistical study, Human, Digestive diseases, Gastric disease, Intestinal disease, Cardiovascular disease, Vascular disease, Malignant hemopathy, Lymphoproliferative syndrome, Non Hodgkin lymphoma, Malignant tumor
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0094423
Code Inist : 002B05B02F. Création : 14/05/1998.