{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:48:40Z","timestamp":1760147320886,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T00:00:00Z","timestamp":1674604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Inappropriate prescription of proton pump inhibitors (PPI) has been widely reported, often lacking initial exclusion of Helicobacter pylori (HP) infection and evaluation of gastric functional status. The aim of this study was to evaluate the utility of gastric functional tests to define the acid output, as well as HP status, in order to better direct PPI therapy prescription. Dyspeptic patients without alarm symptoms from a primary care population were evaluated. For each patient, serum Pepsinogen I (PGI) and II (PGII), gastrin 17 (G17) and anti-HP IgG antibodies (Biohit, Oyj, Finland) were determined. For each subject, data were collected regarding symptoms, past medical history of HP infection, and PPI use. Therapeutic response to PPIs was determined according to PGI and G17 values, where G17 &gt; 7 in the presence of elevated PGI and absence of chronic atrophic gastritis (CAG) was considered an adequate response. Among 2583 dyspeptic patients, 1015\/2583 (39.3%) were on PPI therapy for at least 3 months before serum sampling, and were therefore included in the study. Active HP infection and CAG were diagnosed in 206 (20.2%) and 37 (3.6%) patients, respectively. Overall, an adequate therapeutic response to PPIs was observed in 34.9%, reaching 66.7% at the highest dose. However, 41.1% and 20.4% of patients showed low (G17 1-7) or absent (G17 &lt; 1) response to PPI, regardless of the dosage used. According to gastric functional response, most patients currently on PPI maintenance therapy lack a proper indication for continuing this medication, either because acid output is absent (as in CAG) or because gastrin levels fail to rise, indicating absence of gastric acid negative feedback. Lastly, HP eradication is warranted in all patients, and gastric function testing ensures this pathogen is sought for and adequately treated prior to initiating long-term PPI therapy.<\/jats:p>","DOI":"10.3390\/ijms24032378","type":"journal-article","created":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T01:57:07Z","timestamp":1674698227000},"page":"2378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Appropriateness of Proton Pump Inhibitor Prescription Evaluated by Using Serological Markers"],"prefix":"10.3390","volume":"24","author":[{"given":"Michele","family":"Russo","sequence":"first","affiliation":[{"name":"Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kryssia Isabel","family":"Rodriguez-Castro","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Medicine, ULSS7 \u201cPedemontana\u201d, \u201cAlto Vicentino\u201d Hospital, 36014 Santorso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilisa","family":"Franceschi","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Medicine, ULSS7 \u201cPedemontana\u201d, \u201cAlto Vicentino\u201d Hospital, 36014 Santorso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Ferronato","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Medicine, ULSS7 \u201cPedemontana\u201d, \u201cAlto Vicentino\u201d Hospital, 36014 Santorso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Piera","family":"Panozzo","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pathology, ULSS7 \u201cPedemontana\u201d, \u201cAlto Vicentino\u201d Hospital, 36014 Santorso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Brozzi","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Medicine, ULSS7 \u201cPedemontana\u201d, \u201cAlto Vicentino\u201d Hospital, 36014 Santorso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Di Mario","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8603-863X","authenticated-orcid":false,"given":"Pellegrino","family":"Crafa","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Brandimarte","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Gastroenterology, \u201cCristo Re\u201d Hospital, 00167 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5767-5541","authenticated-orcid":false,"given":"Antonio","family":"Tursi","sequence":"additional","affiliation":[{"name":"Territorial Gastroenterology Service, ASL BAT, 76123 Andria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"741887","DOI":"10.3389\/fendo.2021.741887","article-title":"Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum gastrin Concentrations","volume":"12","author":"Moore","year":"2021","journal-title":"Front. 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