Test and treat for H pylori is 'no better than PPI use'

Test and treat for Helicobacter pylori is neither more clinically effective nor more cost-effective than using proton pump inhibitors (PPIs) for the treatment of dyspepsia, according to UK research presented at the SAPC annual meeting last week.

The study included 669 adults aged 18-65 years with epigastric pain or heartburn who were randomly assigned to test and treat for H pylori, or no testing. All patients received 20mg of omeprazole daily for four weeks.

Over 12 months, the patients' scores on the short-form Leeds dyspepsia questionnaire fell from 15.5 to 6.8 in the test-and-treat group, and from 17.0 to 8.6 in the acid-suppression-only group.

There was no difference between patients with predominant heartburn or epigastric pain at entry.

But test and treat is still worthwhile in the long term, said lead researcher Brendan Delaney, professor of primary care at Birmingham University.

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