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. 2001 May;84(5):419–422. doi: 10.1136/adc.84.5.419

Antibiotic resistance and antibiotic sensitivity based treatment in Helicobacter pylori infection: advantages and outcome

M Street 1, P Caruana 1, C Caffarelli 1, W Magliani 1, M Manfredi 1, F Fornaroli 1, G de'Angelis 1
PMCID: PMC1718745  PMID: 11316688

Abstract

AIMS—To compare two strategies for the eradication of Helicobacter pylori infection.
METHODS—Groups 1 and 2 each consisted of 75 consecutive patients. Patients in group 1 were treated with two antibiotics based on antibiotic susceptibility testing; those in group 2 received amoxycillin and clarithromycin for eight days, together with either ranitidine or omeprazole. Eradication rate was assessed in both groups six months after treatment.
RESULTS—In group 1, H pylori grew in culture in 63/75 cases. Susceptibility testing showed that 35/63 isolates were resistant to metronidazole, 10/63 to clarithromycin, 2/63 to ampicillin, 1/63 to tetracycline, and 5/63 to both clarithromycin and metronidazole. In group 1the infection was eradicated in 96% of the initial 75 subjects, and in 98% of the subjects treated according to the antibiotic assay (62/63). As two patients were lost at follow up the overall eradication rate was 99%. In group 2, eradication was achieved in 61/75 subjects (81%). This was significantly lower than the percentage of eradication observed in group 1 (81% versus 99%).
CONCLUSIONS—Antibiotic susceptibility tests are useful in childhood as a very high percentage of subjects are cured. This approach is costly, but selective antibiotic treatment contributes to limit further development of antibiotic resistance, and money is saved in terms of reinvestigation and further repeated treatments.



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Selected References

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  1. Adamek R. J., Suerbaum S., Pfaffenbach B., Opferkuch W. Primary and acquired Helicobacter pylori resistance to clarithromycin, metronidazole, and amoxicillin--influence on treatment outcome. Am J Gastroenterol. 1998 Mar;93(3):386–389. doi: 10.1111/j.1572-0241.1998.00386.x. [DOI] [PubMed] [Google Scholar]
  2. Adamek R. J., Suerbaum S., Pfaffenbach B., Opferkuch W. Primary and acquired Helicobacter pylori resistance to clarithromycin, metronidazole, and amoxicillin--influence on treatment outcome. Am J Gastroenterol. 1998 Mar;93(3):386–389. doi: 10.1111/j.1572-0241.1998.00386.x. [DOI] [PubMed] [Google Scholar]
  3. Blaser M. J., Chyou P. H., Nomura A. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res. 1995 Feb 1;55(3):562–565. [PubMed] [Google Scholar]
  4. Borody T. J., Shortis N. P., Reyes E. Eradication therapies for Helicobacter pylori. J Gastroenterol. 1998;33 (Suppl 10):53–56. [PubMed] [Google Scholar]
  5. Dixon M. F., Genta R. M., Yardley J. H., Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996 Oct;20(10):1161–1181. doi: 10.1097/00000478-199610000-00001. [DOI] [PubMed] [Google Scholar]
  6. Dore M. P., Osato M. S., Kwon D. H., Graham D. Y., el-Zaatari F. A. Demonstration of unexpected antibiotic resistance of genotypically identical Helicobacter pylori isolates. Clin Infect Dis. 1998 Jul;27(1):84–89. doi: 10.1086/514640. [DOI] [PubMed] [Google Scholar]
  7. Glupczynski Y., Labbé M., Hansen W., Crokaert F., Yourassowsky E. Evaluation of the E test for quantitative antimicrobial susceptibility testing of Helicobacter pylori. J Clin Microbiol. 1991 Sep;29(9):2072–2075. doi: 10.1128/jcm.29.9.2072-2075.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Graham D. Y. Antibiotic resistance in Helicobacter pylori: implications for therapy. Gastroenterology. 1998 Nov;115(5):1272–1277. doi: 10.1016/s0016-5085(98)70100-3. [DOI] [PubMed] [Google Scholar]
  9. Ishizuka J., Kato M., Sugiyama T., Asaka M. [The appropriate time for the assessment of Helicobacter pylori eradication]. Nihon Rinsho. 1999 Jan;57(1):111–115. [PubMed] [Google Scholar]
  10. Jaup B. H., Brandberg A., Stenquist B., Norrby A. Antibiotikaresistens hos stammar av Helicobacter pylori i Göteborg. Bakterierna resistenta mot metronidazol. Lakartidningen. 1998 Jan 21;95(4):279–281. [PubMed] [Google Scholar]
  11. Laine L., Suchower L., Frantz J., Connors A., Neil G. Low rate of emergence of clarithromycin-resistant Helicobacter pylori with amoxycillin co-therapy. Aliment Pharmacol Ther. 1998 Sep;12(9):887–892. doi: 10.1046/j.1365-2036.1998.00378.x. [DOI] [PubMed] [Google Scholar]
  12. Lam S. K., Talley N. J. Report of the 1997 Asia Pacific Consensus Conference on the management of Helicobacter pylori infection. J Gastroenterol Hepatol. 1998 Jan;13(1):1–12. doi: 10.1111/j.1440-1746.1998.tb00537.x. [DOI] [PubMed] [Google Scholar]
  13. López-Vidal Y., Sigfrido Rangel-Frausto M., Calva J. J. Resistencia a antimicrobianos de Helicobacter pylori en un centro de referencia infectológico. Rev Invest Clin. 1998 Jan-Feb;50(1):19–24. [PubMed] [Google Scholar]
  14. Mackin J. G. Violence against trainee paediatricians. Arch Dis Child. 2001 Feb;84(2):106–108. doi: 10.1136/adc.84.2.106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McCarthy D. M. H. pylori infection in non-ulcer patients--to treat or not to treat. The case against treatment. Eur J Surg Suppl. 1998;(582):11–15. doi: 10.1080/11024159850191382. [DOI] [PubMed] [Google Scholar]
  16. Mégraud F. Antibiotic resistance in Helicobacter pylori infection. Br Med Bull. 1998;54(1):207–216. doi: 10.1093/oxfordjournals.bmb.a011671. [DOI] [PubMed] [Google Scholar]
  17. Nilsson F., Walder M. Antibiotikaresistens hos Helicobacter pylori i Malmö, Behandlingsframgång trots antibiotikaresistens. Lakartidningen. 1999 Feb 3;96(5):460–463. [PubMed] [Google Scholar]
  18. Oderda G. Management of Helicobacter pylori infection in children. Gut. 1998 Jul;43 (Suppl 1):S10–S13. doi: 10.1136/gut.43.2008.s10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Olafsdottir E., Forshei S., Fluge G., Markestad T. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child. 2001 Feb;84(2):138–141. doi: 10.1136/adc.84.2.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Partsch C. J., Aukamp M., Sippell W. G. Scrotal temperature is increased in disposable plastic lined nappies. Arch Dis Child. 2000 Oct;83(4):364–368. doi: 10.1136/adc.83.4.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Taylor D. E., Jiang Q., Fedorak R. N. Antibiotic susceptibilities of Helicobacter pylori strains isolated in the Province of Alberta. Can J Gastroenterol. 1998 May-Jun;12(4):295–298. doi: 10.1155/1998/672746. [DOI] [PubMed] [Google Scholar]
  22. Teare L., Peters T., Saverymuttu S., Owen R., Tiwari I. Antibiotic resistance in Helicobacter pylori. Lancet. 1999 Jan 16;353(9148):242–242. doi: 10.1016/S0140-6736(05)77257-3. [DOI] [PubMed] [Google Scholar]
  23. Wreiber K., Olsson-Liljequist B., Engstrand L. Resistensutveckling hos Helicobacter pylori i Sverige. Tendens till ökning av resistens mot klaritromycin. Lakartidningen. 1999 Feb 10;96(6):582–584. [PubMed] [Google Scholar]
  24. van Karnebeek C. D., Naeff M. S., Mulder B. J., Hennekam R. C., Offringa M. Natural history of cardiovascular manifestations in Marfan syndrome. Arch Dis Child. 2001 Feb;84(2):129–137. doi: 10.1136/adc.84.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. van Zwet A. A., Vandenbroucke-Grauls C. M., Thijs J. C., van der Wouden E. J., Gerrits M. M., Kusters J. G., Vandenbrouke-Grauls C. M. Stable amoxicillin resistance in Helicobacter pylori. Lancet. 1998 Nov 14;352(9140):1595–1595. doi: 10.1016/s0140-6736(98)00064-6. [DOI] [PubMed] [Google Scholar]
  26. van Zwet A. A., de Boer W. A., Schneeberger P. M., Weel J., Jansz A. R., Thijs J. C. Prevalence of primary Helicobacter pylori resistance to metronidazole and clarithromycin in The Netherlands. Eur J Clin Microbiol Infect Dis. 1996 Nov;15(11):861–864. doi: 10.1007/BF01691216. [DOI] [PubMed] [Google Scholar]

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