Increased Primary Resistance to Recommended Antibiotics Negatively Affects <i>Helicobacter pylori</i> Eradication

Ecclissato, C.; Marchioretto, M. A. M.; Mendonça, Sérgio; Godoy, Anita Paula Ortiz de; Guersoni, Rosangela A.; Deguer, Maristela; Piovesan, Helenice; Ferraz, José G.; Pedrazzoli, José

doi:10.1046/j.1523-5378.2002.00056.x

Cited by 35 publications

(33 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although clarithromycin resistance is considered an emerging problem worldwide, the observed resistance to clarithromycin in the evaluated population was surprisingly low (8%), if we considerer previous reports from Brazil (8,15) . The finding reinforces the major role of this drug for H. pylori eradication in Brazil.…”

Section: Antimicrobialsmentioning

confidence: 62%

See 1 more Smart Citation

Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Eisig

Silva

Barbuti

et al. 2011

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -The antibiotic susceptibility is the cornerstone for the eradication therapies of Helicobacter pylori. Objectives -To evaluate the prevalence of primary resistance of H. pylori was evaluated in an urban Brazilian population. Methods -H. pylori isolates were obtained from patients submitted to an upper gastrointestinal endoscopy for the evaluation of dyspeptic symptoms.Biopsies from antrum, corpus and fundus were taken to determine the antibiotic susceptibility of H. pylori isolates. The minimal inhibitory concentration of furazolidone and bismuth were routinely determined by agar dilution method and the minimal inhibitory for amoxicillin, clarithromycin, tetracycline, levofloxacin, and metronidazole were routinely determined with the E-test. ResultsFifty-four patients were included. In vitro antimicrobial susceptibility of H. pylori strains were obtained from 39 patients. Resistance to metronidazole was detected in 20 patients (51%), to clarithromycin in 3 patients (8%), to levofloxacin in 9 patients (23%) and to bismuth in 2 patients (5%). There was no observed resistance to amoxicillin, tetracycline or furazolidone. Conclusion -Due to the low amoxicillin and clarithromycin resistance observed in this study, therapies using these antimicrobials remain appropriated first-line H. pylori therapy.

show abstract

Section: Antimicrobialsmentioning

confidence: 62%

“…Unusual resistance rates to tetracycline (7%) have also been observed (24) . This could, at least partially, explain eradication rates as low as 66% observed with a first-line therapy in Brazil (8) . To overcome metronidazole resistance, furazolidone has been used as an alternative in China and South America, including Brazil.…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Eisig

Silva

Barbuti

et al. 2011

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…According to current recommendations [29,30], which consider an effective therapeutic scheme that achieves an eradication rate of at least 80% based on an intention-to-treat analysis, or 90% based on per protocol analysis, the scheme PPI/AC is adequate as the primary option for H. pylori eradication in our country. In our study, the eradication rates were 88.8% (95% CI 86%-92%) per protocol and 82.7% (95% CI 79%-86%) according to the intention to treat.…”

Section: Discussionmentioning

confidence: 99%

“…Triple therapy with PPI, amoxicillin, and clarithromycin has been evaluated in several clinical trials [15][16][17][18][19][20], but data regarding its efficiency and tolerability in Brazil are scarce [21,22,[28][29][30]. This study was designed to evaluate the rate of success and the safety profile of standard therapy in a large cohort of Brazilian patients with PUD and welldocumented H. pylori infection.…”

Section: Introductionmentioning

confidence: 99%

Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Felga

Silva

Navarro–Rodriguez

et al. 2010

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients. Methodology: This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes. Results: Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively. Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P 0.00). Conclusion: PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil.

show abstract

“…Bacteriological culture and histology allow only the semi-quantitative determination of infection, and both require experienced professionals for their execution and the interpretation of results (Christensen et al, 1992;Atherton et al, 1996;El-Zimaity et al, 1996;Leodolter et al, 2001). On the other hand, the RT-PCR assay can accurately detect and quantify five bacterial cells per 200 ng of human DNA as previously described (Mikula et al, 2003;SchabereiterGurtner et al, 2004).…”

mentioning

confidence: 99%

Quantitative real-time PCR for the clinical detection of Helicobacter pylori

et al. 2007

View full text Add to dashboard Cite

Accurate diagnosis of Helicobacter pylori infection is very important in both clinical practice and research. We evaluated the sensitivity of real-time PCR (RT-PCR) for the detection and quantification of Helicobacter pylori using DNA from 91 human gastric biopsy samples divided into three groups: 46 biopsies from untreated patients who according to the references methods were considered H. pylori-negative (group A); 35 biopsies from patients previously treated against H. pylori and considered to be cured by "gold standard" tests (group B); and 10 biopsies from patients H. pylori-positive by all available methods (group C). The sensitivity of the RT-PCR assay was higher than that of standard methods. Of the 81 patients considered to be uninfected according to the references methods, 16 were H. pylori-positive by PCR, 10 of which were patients who had received H. pylori eradication therapy and 6 were untreated patients. Based on these findings we recommend that RT-PCR should be use in addition to standard methods in clinical studies to monitor the results of H. pylori eradication therapy.

show abstract

Increased Primary Resistance to Recommended Antibiotics Negatively Affects Helicobacter pylori Eradication

Abstract: Primary resistance to clarithromycin or amoxicillin may underscore a potentially serious problem for the eradication of H. pylori infection. Testing for bacterial resistance may become necessary to improve therapeutic efficacy.

Cited by 35 publications

References 37 publications

Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

Quantitative real-time PCR for the clinical detection of Helicobacter pylori

Contact Info

Product

Resources

About