COMPARISON OF THE UREASE TEST AND OF DIRECT SMEAR EXAMINATION IN THE CONTROL OF TREATMENT OF HELICOBACTER-PYLORI-INDUCED INFECTION

The sensitivity and specificity of the preformed urease test and of ca rbolfuchsin-stained smears for the diagnosis of the presence of Helico bacter pylori in gastric mucosa were evaluated before and after antimi crobial treatment. The results obtained by culture were used as the re ference point. We studied 41 patients with endoscopically diagnosed du odenal ulcer. Twenty-five of these were treated with furazolidone (100 mg t.i.d.), amoxicillin (500 mg Li.d.) and metronidazole (250 mg t.i. d.) for 5 days and then with only furazolidone (100 mg t.i.d.) for an additional 25 days. The 16 control patients were treated with cimetidi ne (800 mg, 4 times a day). The sensitivity of the urease test and of direct smear examination was 100% before treatment and 84.6% and 92.3% , respectively, after treatment. We conclude that the urease test and carbolfuchsin-stained smears, which are highly sensitive for H. pylori diagnosis, present reduced sensitivity when they are employed for the follow-up of patients treated with antimicrobials.