<p>Eradication Treatment of <em>Helicobacter pylori</em> Infection Based on Molecular Pathologic Antibiotic Resistance</p>

Abstract

Background: Unfortunately, the eradication rate of Helicobacter pylori (H. pylori) treatment is markedly decreasing in recent years and the major reason is antibiotic resistance. Our study was designed to determine the effect and safety of H. pylori eradication treatment based on the molecular pathologic antibiotic resistance. Methods: 261 patients were analyzed retrospectively, including 111 patients who were treated for the first time (one group as First-treated) and 150 patients who failed at least once in bismuth quadruple therapy (another group as Re-treatment). Antibiotic resistance was examined by Real-time PCR detection and conventional PCR and sequencing method. The eradication rate (ER) was compared per intention to treat (ITT) and per protocol (PP) between the two groups. Results: The resistance rates to amoxicillin, clarithromycin, fluoroquinolone and tetracycline were 5.5%, 42.1%, 41.7% and 12.9% in the 111 first-treated patients, and 11.7%, 79.7%, 70.7% and 30.0% in the 150 re-treatment patients. The ERs in the ITT and PP analyses were 92.79% (95% CI, 87.98-97.60%, n=111) and 98.10% (95% CI, 95.48-100%, n=105), respectively, in the first-treated patients and 90.67% (95% CI, 86.01-95.32%, n=150) and 95.10% (95% CI, 91.57-98.64%, n=143), respectively, in the re-treatment patients. No significant differences were shown in the ERs between two group patients, and no serious adverse events were found. Conclusion: H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in both first and retreated patients.

Effect and Safety of Helicobacter pylori Eradication Treatment Based on Molecular Pathologic Antibiotic Resistance in Chinese Elderly People

“…However, culture has a high specificity and a relatively low sensitivity, and certain technique is required. 1 , 14 With the rapid development of molecular biology technology, some molecular markers have been used to predict H. pylori resistance, for example mutations of 23S rRNA, PBP1, gyrA and 16S rRNA for clarithromycin, amoxicillin, fluoroquinolone and tetracycline resistance, respectively. 14–17 Currently, molecular biology methods are practical for susceptibility testing.…”

Correlation Analysis Among Genotype Resistance, Phenotype Resistance and Eradication Effect of Helicobacter pylori

“…In a cohort study in Chile, 16 clarithromycin resistance was negatively correlated with the eradication rate (OR=0.13; 95% CI 0.04–0.49), ie, the eradication rate of patients being infected by clarithromycin-resistant H. pylori strains decreased significantly. The study by Gao et al 23 showed that according to the results of H. pylori resistance gene detection (amoxicillin PBP1 , clarithromycin 23S rRNA, levofloxacin gyrA , tetracycline 16S rRNA), 111 cases underwent initial treatment and 150 cases were treated again. The eradication rate in two groups was >90%, and no serious adverse event occurred.…”

Review – Treatment of Helicobacter pylori infection 2020

“…An unprecedented number of studies last year reported on the important topic of antimicrobial resistance of H pylori strains 24‐60 . These are outlined in Table 1.…”