Helicobacter pylori in Children and Adolescents: Increase of Primary Clarithromycin Resistance, 1997–2000

Crone, Julia Sophia; Granditsch, G; Wd, Huber; Binder, Christa; Innerhofer, Albina; Amann, G; Am, Hirschl

doi:10.1097/00005176-200303000-00012

Cited by 54 publications

(45 citation statements)

References 15 publications

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“…Similar findings have also been reported from other countries and patient populations, [8][9][10] suggesting that the prevalence of CAM-resistant strains has increased worldwide. H. pylori isolates resistant to CAM are known to correlate directly with treatment failures using regimens containing CAM in many countries including Japan, 6,9,11,12 although the significance of CAM rate of second-line treatments using the regimen of PPI, AMOX, and MNZ (PPI/AM) was 97% (61/63) for MNZ-sensitive strains and 82% (18/22) for MNZresistant strains. 18 Their findings suggest that even if the treatment regimen contains this medication PPI/AM regimens do not generally lose their efficacy.…”

supporting

confidence: 89%

Reality and false premises of antimicrobial susceptibility testing for Helicobacter pylori

Miwa

Sato

2003

Journal of Gastroenterology

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supporting

confidence: 89%

Reality and false premises of antimicrobial susceptibility testing for Helicobacter pylori

Miwa

Sato

2003

Journal of Gastroenterology

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“…O regime medicamentoso mais utilizado é a terapia tripla de Maastricht, com claritromicina, amoxicilina e um inibidor de bomba de pró-tons, porém há uma prevalência aumentada de cepas resistentes à claritromicina, e isso tem resultado em taxas de cura não otimizadas em crianças 4,5 . Além disso, o alto custo da claritromicina impede seu uso generalizado em países em desenvolvimento.…”

Section: Introductionunclassified

Furazolidone, tetracycline and omeprazole: a low-cost alternative for <i>Helicobacter pylori</i> eradication in children

Machado¹,

Silva²,

Viriato³

2008

J Pediatr (Rio J)

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ResumoObjetivos: Avaliar furazolidona, tetraciclina e omeprazol como tratamento de primeira linha para Helicobacter pylori em crianças com sintomas digestivos.Métodos: Ensaio clínico aberto, prospectivo e consecutivo. O estudo incluiu pacientes acima de 8 anos com dispepsia funcional, dor abdominal funcional, anormalidades histológicas graves (metaplasia intestinal, atrofia gástrica ou linfoma do tecido linfóide associado às mucosas) ou úlcera péptica. A presença de H. pylori foi definida com base em exame histológico e teste da urease. O regime medicamentoso consistiu de um tratamento de 7 dias com omeprazol, tetraciclina (ou doxiciclina) e furazolidona duas vezes por dia. A erradicação foi avaliada através de endoscopia digestiva alta 2 meses após o tratamento (exame histológico e teste da urease). Avaliações clínicas posteriores foram realizadas 7 dias e 2 meses após o tratamento. Resultados:Foram incluídos 36 pacientes (21 meninas/15 meninos). A idade variou de 8 a 19 anos (média de 12,94±2,89 anos). Na análise por intenção de tratar (n = 36), a taxa de erradicação foi de 83,3% (IC95% 77,1-89,5), ao passo que na análise por protocolo (n = 29), foi de 89,7% (IC95% 84,6-94,7). A adesão foi melhor quando se utilizou doxiciclina, mas as taxas de sucesso foram semelhantes para as duas tetraciclinas. Não houve nenhuma variável associada à falha no tratamento. Foram relatados efeitos colaterais em 17 pacientes (47,2%), principalmente dor abdominal (11/ 30,5%), náusea (sete/19,4%) e vômitos (cinco/13,9%). Conclusão:A terapia tripla com furazolidona e tetraciclina é uma alternativa de baixo custo para o tratamento da infecção pelo H. Age ranged from 8 to 19 years (mean 12.94±2.89 years). On intention-to-treat analysis (n = 36), eradication rate was 83.3% (95%CI 77.1-89.5) whereas in per-protocol analysis (n = 29), it was 89.7% (95%CI 84.6-94.7). Compliance was better when doxycycline was used, but the success rates were similar for the two tetracyclines.There was no variable associated with treatment failure. Side effects were reported in 17 patients (47.2%), mainly abdominal pain (11/ 30.5%), nausea (seven/19.4%) and vomiting (five/13.9%). Conclusion:Triple therapy with furazolidone and tetracycline is a low-cost alternative regimen to treat H. pylori infection.J Pediatr (Rio J). 2008;84(2):160-165

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“…10. the risk of children in Germany to be infected with a clarithromycin-resistant pathogen is 20 % [357] and in Austria even higher [435]. The risk is especially high if the child has already been treated with a new generation macrolide for another indication.…”

Section: Which Diagnostic Tests Are Suitable?mentioning

confidence: 99%

S3-Guideline ”Helicobacter pylori and gastroduodenal ulcer disease” of the German Society for Digestive and Metabolic Diseases (DGVS) in cooperation with the German Society for Hygiene and Microbiology, Society for Pediatric Gastroenterology and Nutrition e. V., German Society for Rheumatology, AWMF-Registration-no. 021 / 001

Fischbach

Malfertheiner²,

Hoffmann³

et al. 2009

Z Gastroenterol

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This guideline updates a prior consensus recommendation of the German Society for Digestive and Metabolic Diseases (DGVS) from 1996. It was developed by an interdisciplinary cooperation with representatives of the German Society for Hygiene and Microbiology, the Society for Pediatric Gastroenterology and Nutrition (GPGE), and the German Society for Rheumatology. The guideline is methodologically based on recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) for providing a systematic evidence-based S 3 level consensus guideline and has also implemented grading criteria according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) process. Clinical applicability of study results as well as specifics for Germany in terms of epidemiology, antibiotic resistance status, diagnostics, and therapy were taken into account.

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Helicobacter pylori in Children and Adolescents: Increase of Primary Clarithromycin Resistance, 1997–2000

Abstract: Eradication of H. pylori should take place only after testing of susceptibility. The general use of clarithromycin in children should be restricted to better-defined indications. Resistance to clarithromycin of H. pylori may also become a future problem for the treatment of adults.

Cited by 54 publications

References 15 publications

Reality and false premises of antimicrobial susceptibility testing for Helicobacter pylori

Reality and false premises of antimicrobial susceptibility testing for Helicobacter pylori

Furazolidone, tetracycline and omeprazole: a low-cost alternative for <i>Helicobacter pylori</i> eradication in children

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Helicobacter pylori in Children and Adolescents: Increase of Primary Clarithromycin Resistance, 1997–2000

Abstract: Eradication of H. pylori should take place only after testing of susceptibility. The general use of clarithromycin in children should be restricted to better-defined indications. Resistance to clarithromycin of H. pylori may also become a future problem for the treatment of adults.

Cited by 54 publications

References 15 publications

Reality and false premises of antimicrobial susceptibility testing for Helicobacter pylori

Reality and false premises of antimicrobial susceptibility testing for Helicobacter pylori

Furazolidone, tetracycline and omeprazole: a low-cost alternative for &lt;i&gt;Helicobacter pylori&lt;/i&gt; eradication in children

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Furazolidone, tetracycline and omeprazole: a low-cost alternative for <i>Helicobacter pylori</i> eradication in children