NSAID gastroprotection — GPhC CRA MCQ

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HardGastrointestinal TherapeuticsNSAID gastroprotectionGPhC CRA

A patient is booked for a urea breath test to confirm Helicobacter pylori eradication. They completed antibiotics five weeks ago but still take omeprazole daily. What instruction is required before the test?

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Correct answer: B — Stop the PPI for two weeks before the eradication test

Stop the PPI for two weeks before the eradication test: PPIs suppress H. pylori and can cause a false-negative urea breath or stool-antigen test; the antibiotic interval is adequate, but a two-week PPI washout is still required. Continue the PPI because only antibiotics affect test sensitivity: Ongoing PPI therapy can suppress organism load and reduce test sensitivity. Stop the PPI for twenty-four hours before the eradication test: A one-day interruption is shorter than the recommended two-week washout. Repeat antibiotics and test on the following day: Testing immediately after antibiotics is unreliable and unnecessary when the completed course was already five weeks ago. Delay another four weeks while continuing the PPI: Additional calendar delay does not correct PPI-related false-negative risk if omeprazole is continued.

Reference: NICE CG184: GORD and dyspepsia — H. pylori treatment: https://www.nice.org.uk/guidance/cg184/chapter/Recommendations; BNF: omeprazole: https://bnf.nice.org.uk/drugs/omeprazole/