Antibiotic resistance of <i>Helicobacter pylori</i> to 16 antibiotics in clinical patients

Shao, Yongfu; Lu, Rongdan; Yang, Yingzhen; Xu, Qiancheng; Wang, Bojun

doi:10.1002/jcla.22339

Cited by 46 publications

(52 citation statements)

References 26 publications

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“…The clinical applicability of RADB may be questionable due to the absence of a preliminary susceptibility test. Although the resistance rates of H. pylori to amoxicillin (0.1%‐4.4%), tetracycline (1.9%‐7.3%), and doxycycline (9.2%) were low in China, leading to a low probability of a strain resistant to amoxicillin or doxycycline in the included patients, data about antibiotic resistance could add further confidence. Unfortunately, due to cost‐effectiveness and patient intentions, the test for antibiotic susceptibility was absent in our study.…”

Section: Discussionmentioning

confidence: 99%

Bismuth, rabeprazole, amoxicillin, and doxycycline as first‐line Helicobacter pylori therapy in clinical practice: A pilot study

Chen

et al. 2019

Helicobacter

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Background Bismuth‐containing quadruple therapy (BQT) is a recommended alternative first‐line therapy for Helicobacter pylori (H. pylori) infection. We aim to evaluate the efficacy and safety of a new BQT with amoxicillin and doxycycline as a first‐line treatment for H. pylori infection in clinical practice. Methods An open, prospective pilot clinical study including H. pylori‐positive outpatients who had never received eradication treatment was carried out. An RADB regimen (10 mg rabeprazole, 1000 mg amoxicillin, 100 mg doxycycline, and 220 mg colloidal bismuth tartrate, all given bid for 14 days) was prescribed by gastroenterologists. H. pylori eradication was confirmed by a 13C‐urea breath test performed at least 6 weeks after the end of treatment. Regimen efficacy was evaluated by per‐protocol (PP) and intention‐to‐treat (ITT) analyses. Results One hundred eighteen patients were included in the study. The eradication rate of RADB was 93.8% (105/112; 95% CI 89.2%‐98.3%) in PP analysis and 89.8% (106/118; 95% CI 84.3%‐95.4%) in ITT analysis. The patient compliance rate was 97.5% (115/118). The adverse event rate was 6.8% (8/118). Adverse events included asthenia, loss of appetite, dry mouth, heartburn, diarrhea, and abdominal pain. All adverse events disappeared after completion of therapy. Conclusion Our results suggest that 14‐day BQT with amoxicillin and doxycycline can be an effective and safe eradication regimen for first‐line therapy against H. pylori infection in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Bismuth, rabeprazole, amoxicillin, and doxycycline as first‐line Helicobacter pylori therapy in clinical practice: A pilot study

Chen

et al. 2019

Helicobacter

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“…In a study by Fink et al [17], monotherapy with 400 mg of ciprofloxacin administered every 8 h resulted in 33% resistance to hospital acquired pseudomonas pneumonia, whilst 500 mg of imipenem given every 6 h or 1000 mg every 8 h resulted in 50% resistance. The resistance rate of levofloxacin was 25% according to a study conducted by Shao Y [18]. In this context, we hope to explore the difference between monotherapy and combination therapy for P. aeruginosa.…”

Section: Discussionmentioning

confidence: 99%

Levofloxacin-ceftazidime administration regimens combat Pseudomonas aeruginosa in the hollow-fiber infection model simulating abnormal renal function in critically ill patients

Jian

2020

BMC Pharmacol Toxicol

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Background: The purpose of this study was to investigate the bactericidal effects of levofloxacin and ceftazidime as both monotherapy and combination therapy, and to determine their effects on resistance suppression in patients with normal and abnormal (Ccr:16-20 mL/min) renal function. Common clinical administration regimens to provide reference values were further evaluated. Methods: The 7-d hollow-fiber infection model was used to inject the Pseudomonas aeruginosa standard strain (ATCC27853), which simulated common clinical administration regimens for patients with different renal function. Ten regimens were stratified into 2 categories based on renal function, and each category contained 3 monotherapy regimens and 2 combination therapy regimens. Total and resistant populations were quantified. Drug concentrations were determined by high-performance liquid chromatography (HPLC). Results: Monotherapy regimens resulted in about 0.5-log-CFU/mL bacterial kill in the total population at 6 or 8 h, whilst combination regimens resulted in 2-to 3-log-CFU/mL within 2 days. For levofloxacin monotherapy regimens in patients with normal renal function, resistance emergence was seen after 6 h, and was seen at 0 h in the ceftazidime monotherapy regimen, as well as in all regimens of patients with abnormal renal function. Although resistant subpopulation in combination regimens with abnormal renal function began to increase at 0 h, there was a definite downward trend after 8 h, while resistant population in the normal renal function group increased after 16 h. Conclusions: Combination therapy had greater bactericidal efficacy and resistance inhibition compared with monotherapy. Studying combination regimens in randomized clinical trials is warranted.

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“…The CLO test is a examination with speed and easy diagnosis, which indeed obtains the first read in 2 hours after collecting samples by endoscopy. However, the CLO test is prone to produce false‐negative results because of several factors, including a quick reaction of CLO test, the treatment of bismuth, proton‐pump inhibitor (PPI), and antibiotics, peptic ulcer bleeding, and ulcer healing medication . Usually, accurate diagnosis with the CLO test takes more than 24 hours to obtain.…”

Section: Discussionmentioning

confidence: 99%

A time‐saving–modified Giemsa stain is a better diagnostic method of Helicobacter pylori infection compared with the rapid urease test

Fan

Chen

Chou

et al. 2019

Clinical Laboratory Analysis

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Abstract Background: Despite having chronic gastritis, most people infected by Helicobacter pylori (H. pylori) are asymptomatic and have no specific clinical signs and symptoms. H. pylori infection can be diagnosed by several detection methods. Giemsa stain and rapid urease test (CLO test) are the most performed tests of H. pylori infection at first-line clinical examination because of their simplicity and reliability. However, the sensitivity of CLO test is significantly reduced in patients with atrophic gastritis and intestinal metaplasia, and the weaknesses of Giemsa stain are higher cost and time-consuming. Methods: The Giemsa stain was modified in several staining solutions and procedures based on the simplified Giemsa technique described by Gray, Wyatt, & Rathbone (1986). The modified Giemsa stain is examined its efficacy and compared with the CLO test using 233 H. pylori-infected patients with gastric disease. Results:The modified Giemsa stain is comparable to the traditional one. Statistical analysis indicated that the modified Giemsa stain obtains greater accuracy in H. pylori-infected patients with gastritis and ulcer than the CLO test (48.1% vs. 43.7%).Moreover, considering the prognosis of different symptoms of gastric diseases, the modified Giemsa stain has a more accurate prognosis than combination symptoms (P = 1.8E-05 vs. P = 5.49E-05). The modified Giemsa stain is confirmed to be better than CLO test using 233 H. pylori-infected patients with gastric disease. Conclusions:The modified Giemsa stain is more simplified and time-saving than traditional Giemsa stain, which is comparable to the traditional one and is confirmed to be better than CLO test using 233 H. pylori-infected patients with gastric disease. In clinical examination, this modified Giemsa stain can be applied to routine examination and provides quick and accurate diagnosis and prognosis to H. pylori-infected patients with gastric diseases. K E Y W O R D S gastric diseases, H. pylori, histological techniques, new Giemsa stain 2 of 5 | FAN et Al.

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Antibiotic resistance of Helicobacter pylori to 16 antibiotics in clinical patients

Abstract: Antibiotic resistance trends of H. pylori is increasing in clinical patients. With the increasing resistance, it is imperative to individualized therapy based on the results of drug susceptibility testing.

Cited by 46 publications

References 26 publications

Bismuth, rabeprazole, amoxicillin, and doxycycline as first‐line Helicobacter pylori therapy in clinical practice: A pilot study

Bismuth, rabeprazole, amoxicillin, and doxycycline as first‐line Helicobacter pylori therapy in clinical practice: A pilot study

Levofloxacin-ceftazidime administration regimens combat Pseudomonas aeruginosa in the hollow-fiber infection model simulating abnormal renal function in critically ill patients

A time‐saving–modified Giemsa stain is a better diagnostic method of Helicobacter pylori infection compared with the rapid urease test

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