Antimicrobial susceptibility testing of &lt;i&gt;Helicobacter pylori &lt;/i&gt;to selected agents by agar dilution method in Shiraz-Iran

Kohanteb, J; Bazargani, Abdollah; Saberi-Firoozi, M; Mobasser, A

doi:10.4103/0255-0857.37342

Cited by 26 publications

(13 citation statements)

References 17 publications

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“…In our population, 34.5% of the bacterial isolates were resistant to ciprofloxacin, which is much higher than typically found. This rate is slightly higher than the 25% rate of ciprofloxacin resistance recently reported for this same region in northern Iran (Talebi Bezmin Adabi, 2009), but is considerably higher than the 4.7% resistance rate recently reported in southern Iran (Kohanteb, et al, 2007). To the best of our knowledge, no studies have yet examined the rate of ciprofloxacin resistance in central Iran.…”

Section: Discussioncontrasting

confidence: 59%

“…In this study, 45.2% of all H. pylori isolates were resistant to clarithromycin, which is an increase over the rates previously reported for this area (25–30%) (Talebi Bezmin Abadi, et al, 2010, Talebi Bezmin Adabi, 2009), and is drastically higher than the recently reported rates of resistance in southern and central Iran, which are <10% (Kohanteb, et al, 2007, Siavoshi, et al, 2010). In fact, this rate of resistance is at the upper end of what is described worldwide (4.0% to 49.2%) (Boyanova and Mitov, 2010).…”

Section: Discussioncontrasting

confidence: 43%

“…This rate of resistance is intermediate as compared to other studies conducted in the Mazandaran region of northern Iran, which reported resistance rates of 6.8% (Talebi Bezmin Abadi , et al , 2010) and 35% (Talebi Bezmin Adabi, 2009). Recent reports from southern Iran indicate similar rates of amoxicillin resistance (about 20%) (Farshad , et al , 2010, Kohanteb , et al , 2007) as compared to central Iran where amoxicillin resistance is lower (7.3%) (Siavoshi , et al , 2010). Interestingly, in our study amoxicillin resistance tended to show a higher prevalence among gastric cancer isolates as opposed to gastritis isolates (Table 1).…”

Section: Discussionmentioning

confidence: 95%

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Frequency of antibiotic resistance in Helicobacter pylori strains isolated from the northern population of Iran

et al. 2011

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Objective The purpose of this study was to evaluate the primary resistance rates of recent clinical Helicobacter pylori isolates to the most commonly used antibiotics in Iran. Materials and Methods 210 patients presenting with gastric maladies between January and July of 2009 were enrolled in this study. Endoscopy was performed, and biopsy specimens were collected from each patient for subsequent bacterial culture of H. pylori. Single colony isolates from each patient were then used for antimicrobial susceptibility testing. The disk diffusion method was used to determine susceptibility patterns. Results 197 of the patients were H. pylori positive (93.8%). The rates of resistance to tetracycline, amoxicillin, ciprofloxacin, metronidazole, clarithromycin, and furizoladone were 37.1%, 23.9%, 34.5%, 65.5%, 45.2%, and 61.4%, respectively. A significant association between amoxicillin resistance and disease state (P <0.05) was identified. Furthermore, some double, triple, quadruple, and quintuple combinations of antibiotic resistance were found to be associated with disease state. Conclusions This study evaluated the prevalence of H. pylori resistance to the most commonly prescribed antibiotics used in Iran and showed that resistance rates were generally higher than previously reported. This data adds to the growing body of evidence that suggests there is increasing antibiotic resistance among H. pylori isolates, which likely is responsible for the decreasing efficacy of anti-H. pylori therapy at the local and global level. Hence, there is a need for continued monitoring of resistance patterns, especially at the local level, and for incorporation of that information into treatment regimens for H. pylori infections.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 95%

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Frequency of antibiotic resistance in Helicobacter pylori strains isolated from the northern population of Iran

et al. 2011

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“…The three studies from Italy suggest that this might be an effective regimen whereas the one from China did not. The study from China, a high metronidazole resistance country, also compared 10 day therapy with doxycycline or tetracycline and the results were both poor 64 . Further studies with 14 day therapy and with 200 mg of doxycycline b.i.d.…”

Section: Doxycyclinementioning

confidence: 99%

How to Effectively Use Bismuth Quadruple Therapy

Graham

Lee

2015

Gastroenterology Clinics of North America

134

174

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Bismuth triple therapy was the first truly effective Helicobacter pylori eradication therapy. The addition of a proton pump inhibitor largely overcame the problem of metronidazole resistance. Resistance to its being the primary first line therapy have centered on convenience (the large number of tablets required) and side effects causing difficulties with patient adherence. Understanding why the regimen is less successful in some regions remains unexplained in part because of the lack of studies including susceptibility testing. A number of modifications have been proposed such as twice-a-day therapy which addresses both major criticism but the studies with susceptibility testing required to prove its effectiveness in high metronidazole resistance areas are lacking. Most publications lack the data required to understand why they were successful or failed (e.g., detailed resistance and adherence data) and are therefore of little value. We discuss and provide recommendations regarding variations including substitution of doxycycline, amoxicillin, and twice a day therapy. We describe what is known and unknown and provide suggestions regarding what is needed to rationally and effectively use bismuth quadruple therapy. Its primary use is when penicillin cannot be used or when clarithromycin and metronidazole resistance is common. Durations of therapy less than 14 days are not recommended.

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“…Since resistance to amoxicillin, tetracycline, and furazolidone have been reported from Iran [17;18;52–55], one cannot assume that all infections are susceptible. Future studies should include collection and storage of biopsies for culture and susceptibility testing so that the results can be interpreted in relation to the susceptibility patterns.…”

Section: Recommendations For Future Studiesmentioning

confidence: 99%

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

et al. 2017

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Background Treatment success of H. pylori eradication therapy has declined worldwide largely because of increased antimicrobial resistance. New therapeutic approaches are needed, especially for countries like Iran, where resistance to commonly used drugs is already widespread and traditional H. pylori therapies produce poor cure rates. Aim to review the results of quadruple therapy trials containing bismuth and furazolidone in Iran. Methods We searched PubMed, Google scholar as well as the references of all published papers for studies done in Iran, utilizing furazolidone in the treatment of H. pylori infections. The target population was 4 drug studies that utilized a combination of bismuth, furazolidone, amoxicillin, or tetracycline plus a proton pump inhibitor. Results Eighteen studies with 22 arms including 1713 subjects were found. The weighted mean cure rate for 14-day studies (6 studies) using 200 mg b.i.d. furazolidone was 80% intention-to-treat (ITT) and 87% per protocol (PP). Studies using 100 mg b.i.d (3 studies) were less effective (weighted mean ITT cure rate = 67%). One small 14 day study with furazolidone 100 mg q.i.d. achieved cure rates of 94.5% ITT and PP. Conclusions Although furazolidone-bismuth quadruple therapy proved relatively effective in Iran, furazolidone-containing regimens remain to be optimized. Based on these data and results from China, it appears likely that 14 day therapy containing furazolidone 100 mg t.i.d. or q.i.d. is likely to provide the highest cure rates with lowest side effects; this remains to be experimentally tested. Detailed suggestions for further development of furazolidone-containing regimens are provided.

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Antimicrobial susceptibility testing of <i>Helicobacter pylori </i>to selected agents by agar dilution method in Shiraz-Iran

Cited by 26 publications

References 17 publications

Frequency of antibiotic resistance in Helicobacter pylori strains isolated from the northern population of Iran

Frequency of antibiotic resistance in Helicobacter pylori strains isolated from the northern population of Iran

How to Effectively Use Bismuth Quadruple Therapy

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

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