Correlation of registered drug packs with Maastricht V/Florence Consensus Report and national treatment guidelines for management of Helicobacter pylori infection

Abstract

High prevalence of Helicobacter pylori infection, the complexity for its treatment, poor correlation of registered drug packs or poor patient adherence to the treatment may contribute to antibiotic resistance and healthcare costs. The aim of the present study was to investigate whether registered drug packs are in accordance with European and national guidelines for H pylori eradication with reference to the number of drug units. In this study, we considered treatment options for the management of H pylori infection recommended by the Maastricht V/Florence Consensus Report and by national guidelines in the United Kingdom (UK), Croatia, Italy and Slovenia for adults. Drugs proposed by the guidelines were identified in national drug databases in July of 2019. When considering correlation for 10‐day treatment regimens, drug packs registered in Croatia could not be matched with recommendations for sequential therapies. A number of proposed treatments could not be matched due to small variety of drug packs in Croatia. Drug packs registered in the UK more often matched recommended 14‐day treatment regimens and national guidelines. With reference to European guidelines, 10‐day treatments could more frequently be matched in Italy and in Slovenia. Furthermore, results of this study indicate that there is smaller variety in drug pack sizes registered in Croatia and Slovenia when compared to UK and Italy. Considering poor correlation of drug packs with treatment guidelines for H pylori, adherence to antimicrobial treatment and proper disposal of antimicrobials is warrant. Discussing adherence to antimicrobial treatment with patients should be introduced as a standard of patient care and education.

Antimicrobial Resistance: Physicians' and Pharmacists' Perspective

“…6 Recent studies have raised question about the ability of physicians to follow guidelines due to the limited availability of appropriate drug packs. 7,8 This stresses the importance of different skills needed among physicians and an ever-growing need for new and up-to-date information and education. Furthermore, with most of the antibiotic consumption being in primary care, 9 pharmacists have a unique opportunity to contribute to the management of AMR as well to affect patients' adherence to treatment and management of leftover antimicrobials.…”

Adherence to Maastricht V/Florence consensus report for the management ofHelicobacter pyloriinfection among primary care physicians and medical students in Croatia: A cross‐sectional study

“…Our previous research showed poor adherence of drug packaging with European and national guidelines for management of H pylori infection for a portion of EU countries. Unavailability of drugs that are an integral part of the first treatment line is also important problem for implementation of Maastricht V/Florence consensus report in clinical practice 30,31 . Furthermore, most recent data on H. pylori resistance rate in Croatia were published in 2012 13 …”

Management of risk factors for gastrointestinal bleeding in patients receiving anticoagulant therapy

“…Пациентам с высоким риском геморрагических осложнений необходима коррекция модифицируемых ФР ЖКК: эрадикация H. pylori при наличии хронического хеликобактерного гастрита (показана всем пациентам согласно Маастрихтскому консенсусу V); отказ или минимизация приема НПВП и глюкокортикостероидов; переход на более безопасные для ЖКТ НПВП и антиагреганты (высокоселективные ингибиторы циклооксигеназы-2, блокаторы рецепторов к аденозиндифосфату), использование гастропротективной и кислотосупрессивной терапии [15,29,30,32]. Общераспространенной клинической практикой является назначение ингибиторов протонной помпы (ИПП) для профилактики и лечения эрозивно-язвенных поражений пищевода, желудка и двенадцатиперстной кишки.…”

“…ИПП должны назначаться всем пациентам, набравшим ≥3 баллов по шкале HAS-BLED. Данные препараты существенно не отличаются по эффективности, однако при лечении полиморбидных пациентов с полипрагмазией целесообразно выбирать ИПП, имеющие минимальные риски неблагоприятных лекарственных взаимодействий -рабепразол и пантопразол [15,29,30,[32][33][34].…”