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Titolo:
Helicobacter pylori-associated peptic ulcer disease in older patients - Current management strategies
Autore:
Pilotto, A;
Indirizzi:
Dept Geriatr, Digest Physiopathol Ctr Elderly, Vicenza, Italy Dept Geriatr Vicenza Italy est Physiopathol Ctr Elderly, Vicenza, Italy
Titolo Testata:
DRUGS & AGING
fascicolo: 7, volume: 18, anno: 2001,
pagine: 487 - 494
SICI:
1170-229X(2001)18:7<487:HPPUDI>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RANDOMIZED CONTROLLED TRIAL; PROTON PUMP INHIBITOR; ELDERLY PATIENTS; MEDICARE PATIENTS; TRIPLE THERAPIES; ANTIBIOTIC-RESISTANCE; GASTRODUODENAL DAMAGE; ERADICATION THERAPY; INFECTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
63
Recensione:
Indirizzi per estratti:
Indirizzo: Pilotto, A Osped S Bortolo, Unita Operat Geriatr, Fisiopatol Digest Anziano, Via Rodolfi,37, I-36100 Vicenza, Italy Osped S Bortolo Via Rodolfi,37 Vicenza Italy I-36100 za, Italy
Citazione:
A. Pilotto, "Helicobacter pylori-associated peptic ulcer disease in older patients - Current management strategies", DRUG AGING, 18(7), 2001, pp. 487-494

Abstract

The incidence of peptic ulcer and its severe complications, i.e. bleeding or perforation, is increasing in elderly patients worldwide. The prevalenceof Helicobacter pylori infection in patients with peptic ulcer aged over 65 years has been reported to range from 58 to 78%. However, in elderly patients hospitalised for ulcer disease, the rate of diagnostic screening or treatment for H. pylori infection was less than 60%, and only 50 to 73% of patients who had a positive H, pylori test were treated with antibacterials. The eradication of H. pylori infection is known to be of proven benefit for elderly patients with H. pylori-associated ulcer disease. Significant improvement of the clinical outcome, and reduction of ulcer recurrences, symptoms and histological signs of ulcer-associated chronic gastritis activity, as well as decreased costs in elderly healthcare, all result from successful therapy. Proton pump inhibitor (PPI)-based triple therapy regimens including clarithromycin, amoxicillin and/or nitroimidazoles are highly effectiveand well tolerated in elderly patients, particularly if therapy is of a short duration and low doses of both the PPI and clarithromycin are used. Resistance of H. pylori to antibacterials and low compliance are the majorreasons for treatment failure. Surveillance of H. pylori susceptibility toantibacterials at the regional level and enhanced compliance programmes give promising results that suggest new approaches to anti-H. pylori treatment, especially in elderly patients. The role of H. pylori infection in nonsteroidal anti-inflammatory drug (NS AID)-related peptic ulcer still remains controversial. At present, no clear evidence supports the testing and treatment of H. pylori infection for the prevention of drug-related peptic ulcerin elderly patients receiving an NSAID or aspirin (acetylsalicylic acid). After therapy, elderly patients with peptic ulcer may be re-evaluated by invasive methods, i.e. endoscopy and gastric biopsies, or by noninvasive methods. In elderly patients, the C-13-urea breath test demonstrated significantly higher sensitivity, specificity and diagnostic accuracy fur detecting H. pylori infection than anti-H. pylori antibodies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 18:45:25