Identification and Treatment of Helicobacter pylori.htm

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FromAmerican Journal of Health-System Pharmacy

ASHP Therapeutic Position Statement on the Identification and Treatment of Helicobacter pylori-Associated Peptic Ulcer Disease in AdultsDeveloped by the ASHP commission on therapeutics and approved by the ASHP board of directors on November 11, 2000

[Am J Health-Syst Pharm 58(04):331-337, 2001. © 2001 ASHP, Inc.]

Statement of PositionIn February 1994 a National Institutes of Health (NIH) consensus panel concluded that patients with peptic ulcer disease and Helicobacter pylori infection require treatment with antimicrobial agents in combination with antisecretory drugs (i.e., histamine H2-receptor antagonists, proton-pump inhibitors), whether on first presentation with the illness or on recurrence.[1] Although professional organizations and societies have publicly supported the NIH panel,[2,3] many patients with peptic ulcer disease continue to receive inadequate treatment.

Effective treatment regimens for eradicating H. pylori infection include a variety of combinations of prescription and nonprescription agents. The complexity of these treatment regimens heightens the importance of patient education and monitoring to ensure compliance with and optimal response to therapy. ASHP encourages and supports pharmacists' involvement in the identification and treatment of patients with H. pylori-associated disease with the objective of decreasing peptic ulcer recurrence rates and associated morbidity and mortality. In addition, ASHP encourages pharmacists to work with other health care professionals in providing these services.

An association of H. pylori with peptic ulcer disease in children has been more difficult to prove. This is because H. pylori infection and peptic ulcer disease are both infrequent in children.[4] This Therapeutic Position Statement was developed for adult patients.

continued...

The following individuals are acknowledged for drafting this document: Shauna Buring, PHARM.D., Director of Drug Information, Auburn University, Al. Wayne , PHARM.D., FASHP, Director, Pharmacy Department, Novation, Irving, TX. Joette M. Meyer, PHARM.D., Clinical Pharmacology Reviewer, US Food and Drug Administration, Center for Drug Evaluation and Research Division of Drug Evaluation III (HFD-880), Room S-402, Rockville, MD 20850. Segal, PH.D., Professor and Chair University of Florida Research Foundation Professor, College of Pharmacy, University of Florida, Gainesville, FL.

The following professional organizations and persons submitted comments on the draft document: the American College of Clinical Pharmacy, the American Gastroenterological Association, the American Pharmaceutical Association, the Centers for Disease Control & Prevention, Brousal, Pharm.D., T. Fong, Pharm.D., Carla Frye, Pharm.D., R. Garnett, Pharm.D., Ann Halloran, Pharm.D., Ila Mehra , Pharm.D., Morreale, Pharm.D., Ralph H. Raasch, Pharm.D., Marisel Segarra-Newnham, Pharm.D., Weber, Pharm.D., Helen S. Yee, Pharm.D. The bibliographic citation for this document is as follows: American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the Identification and Treatment of Helicobacter pylori-Associated Peptic Ulcer Disease in Adults.

ASHP Therapeutic Position Statements: ASHP Therapeutic Position Statements are concise documents that respond to therapeutic issues of concern to health care consumers and pharmacists. They are drafted by one or more ASHP members with relevant expertise and undergo review by the ASHP Commission on Therapeutics. The documents are also reviewed by professionals, including representatives from other disciplines and other organizations, who were not involved in the development process. Therapeutic Position Statements are approved by the ASHP Commission on Therapeutics and the ASHP Board of Directors to become official ASHP practice standards.

Section 1 of 7

CONTENTS

Statement of PositionBackgroundTesting for H. Pylori InfectionTreatment RegimensAntimicrobial ResistanceRole of the PharmacistSummaryReferences

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