Research: Oslo universitetssykehus HFOslo universitetssykehus HF · Department of Infectious DiseasesNorway · Oslo
[show abstract] [hide abstract]
ABSTRACT: In this study we assessed the accuracy of IgG serology and other tests in confirming Helicobacter pylori eradication. The outcome of anti-H. pylori therapy was established by at least two of the following tests: rapid urease test (RUT), culture, 14C urea breath test (non-capsule or capsule UBT), and IgG serology (Orion Diagnostica Pyloriset New EIA-G). Successful H. pylori eradication was confirmed in 698 of 794 patients (88%). The percentage decrease in IgG antibody titre was related to the patients' pre-treatment IgG titre and time interval after treatment. A decrease in IgG titres of 40% or more confirmed H. pylori eradication with 100% specificity, whereas the sensitivity was 82%, 90%, 98%, and 98% 3, 4, 5, and 6 months after therapy, respectively. The 40% cut-off confirmed eradication 3 to 6 months after therapy in 328 of 339 patients (97%) with pre-treatment IgG titres of >700, in 36 of 45 patients (80%) with pre-treatment titres of 300-700, and in 5 of 12 patients (42%) with pretreatment titres of <300. The sensitivity and specificity of the other tests 2 months after treatment were as follows: RUT, 84% and 100%; culture, 88% and 100%; non-capsule UBT, 100% and 89%; and capsule UBT, 100% and 97%. A decrease in IgG antibody titre of 40% or more 3 to 6 months after therapy and the capsule 14C UBT at the 2-month follow-up were both highly accurate in confirming H. pylori eradication.Scandinavian Journal of Gastroenterology 07/1998; 33(7):710-5. · 2.02 Impact Factor
Article: Accuracy of seven different tests for the diagnosis of Helicobacter pylori infection and the impact of H2-receptor antagonists on test results.[show abstract] [hide abstract]
ABSTRACT: In this study we compared the accuracy of seven diagnostic tests in diagnosing Helicobacter pylori infection. Over 1 year 351 consecutive dyspeptic patients were tested for H. pylori infection by means of antral biopsy specimens for the rapid urease test (RUT), culture, microscopy (acridine stain), and the laboratory urease test (LUT) and, in addition, with 14C urea breath test (UBT), IgG serology, and IgA serology (Orion Diagnostica Pyloriset New EIA-G and New EIA-A). The criterion for H. pylori infection was a minimum of three positive tests. Before being tested, 38% of the patients had used an H2-receptor antagonist (H2RA). Two-hundred and twenty-four patients (64%) were H. pylori-positive. The sensitivity and specificity of the tests were as follows (percentages): RUT, 85, 99; culture, 93, 100; microscopy, 81, 98; LUT, 80, 100; UBT, 95, 95; IgG serology, 99, 91; and IgA serology, 88, 91. The accuracy of the RUT and LUT was reduced in patients receiving H2RA therapy (P=0.04 and 0.01, respectively). Culture, UBT, and IgG serology were all superior to the other four tests in diagnosing H. pylori infection. Invasive urease-based tests were less accurate in patients receiving H2RAs.Scandinavian Journal of Gastroenterology 05/1998; 33(4):364-9. · 2.02 Impact Factor
Article: [Infectious endocarditis]J. B. HaugTidsskr Nor Laegeforen. 01/1998; 118(2):213.
Article: Highly effective second-line anti-Helicobacter pylori therapy in patients with previously failed metronidazole-based therapy.[show abstract] [hide abstract]
ABSTRACT: In this study we compared the cure rates of two clarithromycin-based regimens in patients in whom anti-Helicobacter pylori therapy had previously failed. Thirty-three patients were randomized to receive either regimen OAC (20 mg omeprazole, 750 mg amoxicillin, and 250 mg clarithromycin) or BTC (240 mg bismuth subcitrate, 750 mg oxytetracycline, and 250 mg clarithromycin), all twice daily for 10 days. A further 28 patients were all treated with OAC. Previously failed therapy included combinations of bismuth (B), omeprazole (O), tetracycline (T), metronidazole (M), amoxicillin (A), or clarithromycin (C) in BTM (n = 48), OAM (n = 13), OA (n = 7), OCM (n = 2), or BCM (n = 1). H. pylori infection was confirmed by culture of biopsy specimens, and antimicrobial susceptibility testing was performed with the E test. H. pylori infection was cured in all patients (n = 18) with OAC and in 8 patients (53%) with BTC (P = 0.001) in the randomized group and in 27 patients (96%) receiving OAC in the open-label group. Ten-day OAC is highly effective and superior to BTC in patients in whom metronidazole-based treatment has previously failed.Scandinavian Journal of Gastroenterology 01/1998; 32(12):1209-14. · 2.02 Impact Factor
Dag Berild, Jon Birger Haug[show abstract] [hide abstract]
ABSTRACT: The Norwegian antibiotic policy emphasises use of narrow-spectrum antibiotics and has been regarded as successful. We have a low occurrence of antibiotic resistance, but hospital use of antibiotics in general, and broad-spectrum antibiotics specifically, has increased substantially the last 10 years. We now see a trend towards increasing antibiotic resistance, which will inevitably lead to the same serious resistance problems in Norway as abroad. We have assessed resistance profiles for the most common human pathogens in Norway in the light of literature retrieved through a non-systematic search of PubMed and Norwegian literature on rational antibiotic use. The article emphasises pharmacodynamic and pharmacokinetic aspects, as well as ecological side effects of antibiotics and discusses rational treatment of the most common infections in Norwegian hospitals. Most research in this context is performed in settings with different antibiotic resistance patterns and attitudes towards antibiotic treatment than in Norway; few studies have focused on rational antibiotic use in Norwegian hospitals. We conclude that "old-fashioned" narrow-spectrum antibiotics can still be used in Norwegian hospitals, as there is little resistance to these agents. It is still possible to treat most infections in Norwegian hospitals with narrow-spectrum antibiotics. We encourage physicians to adhere to the Norwegian antibiotic therapy tradition.Tidsskrift for den Norske laegeforening 11/2008; 128(20):2335-9.