Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio

Background: Epidemiological differences suggest that treatments for H. pylori eradication should be locally validated. Aim: To perform a cost benefit study of different treatment options for H. pylori infection. Patients and methods: One hundred and sixty-seven patients with active duodenal ulcer an...

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Autores principales:	Rollán R,Antonio, Giancaspero P,Rossana, Acevedo G,Claudia, Fuster S,Francisco, Hola Ch,Karen
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2000
Materias:	Amoxycillin Antibiotics combined Clarithromycin Cost-benefit analysis Helicobacter pylori Proton pump
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000400002
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spelling	oai:scielo:S0034-988720000004000022005-11-29Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficioRollán R,AntonioGiancaspero P,RossanaAcevedo G,ClaudiaFuster S,FranciscoHola Ch,Karen Amoxycillin Antibiotics combined Clarithromycin Cost-benefit analysis Helicobacter pylori Proton pump Background: Epidemiological differences suggest that treatments for H. pylori eradication should be locally validated. Aim: To perform a cost benefit study of different treatment options for H. pylori infection. Patients and methods: One hundred and sixty-seven patients with active duodenal ulcer and H. pylori infection who completed a 2-week treatment with one of the following regimens were included: famotidine plus amoxycillin plus metronidazole (FAM), omeprazole plus amoxycillin plus tinidazole (OAT) or lansoprazole plus clarithromycin plus amoxycillin in 3 (LAC1) or 2 (LAC2) daily doses. We compared efficacy, adverse effects and cost. Results: Eradication rate was 74.6, 72.9, 96.4 y 91.7% for FAM, OAT, LAC1 and LAC2 respectively (p<0.05). Direct cost ranged from US$ 50 for FAM to US$ 220 for LAC1. A decision analysis was carried out in a model including direct and indirect costs and considering retreatment with antibiotics after the first treatment failure and one-year treatment with H2-blockers in case of a second failure. FAM was selected as the most cost-effective option, with an estimated cost of about US$ 300 ± 148 per patient. However, cost associated to LAC2 was very similar (US$ 320 ± 58) and the lower standard deviation suggests less variation. Sensitivity analyses, considering reasonable fluctuation in parameters such as eradication rate, cost and follow-up period suggest that a regimen containing a proton pump inhibitor, clarithromycin and amoxycillin may be the most cost-effective treatment. Conclusions: These results should be confirmed in other settings, specially in ordinary clinical practice, far from clinical research. (Rev Méd Chile 2000; 128: 367-77)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.128 n.4 20002000-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000400002es10.4067/S0034-98872000000400002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Amoxycillin Antibiotics combined Clarithromycin Cost-benefit analysis Helicobacter pylori Proton pump
spellingShingle	Amoxycillin Antibiotics combined Clarithromycin Cost-benefit analysis Helicobacter pylori Proton pump Rollán R,Antonio Giancaspero P,Rossana Acevedo G,Claudia Fuster S,Francisco Hola Ch,Karen Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio
description	Background: Epidemiological differences suggest that treatments for H. pylori eradication should be locally validated. Aim: To perform a cost benefit study of different treatment options for H. pylori infection. Patients and methods: One hundred and sixty-seven patients with active duodenal ulcer and H. pylori infection who completed a 2-week treatment with one of the following regimens were included: famotidine plus amoxycillin plus metronidazole (FAM), omeprazole plus amoxycillin plus tinidazole (OAT) or lansoprazole plus clarithromycin plus amoxycillin in 3 (LAC1) or 2 (LAC2) daily doses. We compared efficacy, adverse effects and cost. Results: Eradication rate was 74.6, 72.9, 96.4 y 91.7% for FAM, OAT, LAC1 and LAC2 respectively (p<0.05). Direct cost ranged from US$ 50 for FAM to US$ 220 for LAC1. A decision analysis was carried out in a model including direct and indirect costs and considering retreatment with antibiotics after the first treatment failure and one-year treatment with H2-blockers in case of a second failure. FAM was selected as the most cost-effective option, with an estimated cost of about US$ 300 ± 148 per patient. However, cost associated to LAC2 was very similar (US$ 320 ± 58) and the lower standard deviation suggests less variation. Sensitivity analyses, considering reasonable fluctuation in parameters such as eradication rate, cost and follow-up period suggest that a regimen containing a proton pump inhibitor, clarithromycin and amoxycillin may be the most cost-effective treatment. Conclusions: These results should be confirmed in other settings, specially in ordinary clinical practice, far from clinical research. (Rev Méd Chile 2000; 128: 367-77)
author	Rollán R,Antonio Giancaspero P,Rossana Acevedo G,Claudia Fuster S,Francisco Hola Ch,Karen
author_facet	Rollán R,Antonio Giancaspero P,Rossana Acevedo G,Claudia Fuster S,Francisco Hola Ch,Karen
author_sort	Rollán R,Antonio
title	Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio
title_short	Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio
title_full	Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio
title_fullStr	Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio
title_full_unstemmed	Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio
title_sort	tratamiento de la infección por helicobacter pylori en pacientes con úlcera duodenal: estudio de costo-beneficio
publisher	Sociedad Médica de Santiago
publishDate	2000
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000000400002
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Tratamiento de la infección por Helicobacter pylori en pacientes con úlcera duodenal: Estudio de costo-beneficio

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