Clarithromycin-Resistant Genotypes and Eradication of Helicobacter Pylori

Francavilla, Ruggiero; Lionetti, Elena; Castellaneta, Stefania; Margiotta, M.; Piscitelli, Domenico; Lorenzo, Lorenzo; Cavallo, Luciano; Ierardi, Enzo

doi:10.1016/j.jpeds.2010.02.007

Cited by 171 publications

(47 citation statements)

References 24 publications

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“…In our study, mutation A2142C was not found in any patient, A2143G and A2142G mutations were found to be the most frequent. There are several other studies whose results are consistent with our study 20,28,[29][30][31] . The eradication ratio was lower for patients detected to have A2143G mutation 29 .…”

Section: Discussionsupporting

confidence: 93%

“…There are several other studies whose results are consistent with our study 20,28,[29][30][31] . The eradication ratio was lower for patients detected to have A2143G mutation 29 . Other studies about the use of clarithromycin in the eradication treatment of H. pylori assert that the existence of A2143G mutation negatively effects the treatment process 27,30 .…”

Section: Discussionsupporting

confidence: 93%

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Clarithromycin resistance and 23S rRNA gene point mutations of Helicobacter pylori infection in children

et al. 2016

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This study aims to evaluate Helicobacter pylori with clarithromycin resistant genotypes in Manisa region, Turkey. Two hundred patients, who received diagnosis of Helicobacter pylori infection histopathologically, were included. The sex, age and endoscopy indications of the patients were recorded. Polymerase chain reaction method was applied to determine the clarithromycin resistance rate and resistance genotypes at the histologic sections prepared from gastric biopsies that had been embedded in paraffin after fixation by formalin. Helicobacter pylori resistance to clarithromycin was found in 19/200 (9.5%) patients. 10/19 (52.6%) of these clarithromycin-resistant patients had A2143G mutation and 9/19 (47.4%) had A2142G mutation. A2142C mutation on 23S rRNA gene was not detected for any of the patients. Clarithromycin can be used as a first step treatment in the eradication of Helicobacter pylori for the children in our region; if the treatment fails for some patients, clarithromycin resistance, especially A2143G and A2142G mutations should be considered.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Clarithromycin resistance and 23S rRNA gene point mutations of Helicobacter pylori infection in children

et al. 2016

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“…In the paediatric population we found a 25% prevalence of resistance in a sample of 168 H. pylori positive children observed between 2002 and 2007, mirroring other data from European countries, where high values reflect the environmental conditions of southern areas [14] .…”

Section: Prevalence Of Resistance To Clarithromycinsupporting

confidence: 85%

Primary clarithromycin resistance toHelicobacter pylori: Is this the main reason for triple therapy failure?

Giorgio

Principi²,

Francesco³

et al. 2013

WJGP

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“…The benefit of the sequential therapy to treat patients at risk for clarithromycin-resistant strains, such as subjects with co-infections and especially respiratory tract infections in the present study, should be evaluated further, as the data from the literature are controversial (Francavilla et al, 2010;Rimbara et al, 2011). These patients can be treated empirically by bismuth quadruple therapy, fluoroquinolone-based regimens or by triple combinations of PPI (ranitidine bismuth), amoxicillin (or tetracycline) and metronidazole (Mégraud, 2004b).…”

Section: Discussionmentioning

confidence: 99%

“…However, it should be stressed that metronidazole resistance has a lower effect on the eradication success compared with that to clarithromycin or fluoroquinolones, and the sequential therapy may overcome clarithromycin resistance in most H. pylori strains according to Francavilla et al (2010).…”

Section: Discussionmentioning

confidence: 99%

Numerous risk factors for Helicobacter pylori antibiotic resistance revealed by extended anamnesis: a Bulgarian study

Boyanova

Ilieva

Gergova

et al. 2012

Journal of Medical Microbiology

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The aim of this study was to assess risk factors for primary Helicobacter pylori antibiotic resistance by an extended anamnesis. In total, 519 H. pylori strains from untreated symptomatic adults who answered a questionnaire were evaluated. Strain susceptibility was assessed by a breakpoint susceptibility test. Primary resistance rates were 29.5 % for metronidazole, 17.9 % for clarithromycin, 7.3 % for metronidazole+clarithromycin, 4.0 % for tetracycline and 10.8 % for ciprofloxacin. On multivariate analysis, younger (¡65 years) age was an independent predictor for metronidazole resistance. To our knowledge, for the first time, being a member of the health-care profession was revealed as a risk factor for H. pylori resistance to metronidazole and both metronidazole and clarithromycin. Respiratory and urinary tract infections were independent predictors of clarithromycin and ciprofloxacin resistance, respectively. The presence of co-infections was an independent risk factor for clarithromycin, metronidazole and ciprofloxacin resistance. Surprisingly, female sex was the only predictor for tetracycline resistance. The antibiotic resistance rates were not associated with disease type, place of residence, birthplace, educational level, non-steroidal anti-inflammatory drug or proton pump inhibitor use, smoking or dietary factors, such as consumption of coffee, yogurt, green tea, raw garlic, raw onion, honey or meat. There was a trend for higher metronidazole resistance in strains from diabetic patients. In conclusion, the extended anamnesis of H. pylori-positive patients should include data on patient age, sex, whether they are in the health-care profession, co-infections and possibly diabetes to improve the choice of empiric therapy. Tailored treatment based on the extended anamnesis is suggested, and susceptibility testing of the strains is recommended for patients at risk for antibiotic resistance, especially to clarithromycin, fluoroquinolones or both metronidazole and clarithromycin.

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Clarithromycin-Resistant Genotypes and Eradication of Helicobacter Pylori

Cited by 171 publications

References 24 publications

Clarithromycin resistance and 23S rRNA gene point mutations of Helicobacter pylori infection in children

Clarithromycin resistance and 23S rRNA gene point mutations of Helicobacter pylori infection in children

Primary clarithromycin resistance toHelicobacter pylori: Is this the main reason for triple therapy failure?

Numerous risk factors for Helicobacter pylori antibiotic resistance revealed by extended anamnesis: a Bulgarian study

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