Antibiotic resistance of Helicobacter pylori in pediatric patients -- 10 years' experience.
The aim of this study was to assess the pattern of evolution of resistance to antibiotics in Helicobacter pylori isolated from children who underwent upper endoscopy with antral biopsy during a 10-year period (2001-2010). We retrospectively analyzed data of all children (n = 3,008) who underwent upp...
| Publicado en: | European Journal of Pediatrics Vol. 171; no. 9; pp. 1325 - 1331 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Sep2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104299541&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104299541 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Sep2012 vid: 171 iid: 9 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104299541 104299541 NLM22430353 2011771651 10.1007/s00431-012-1722-8 NLM22430353 104299541 ppf: 1325 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Antibiotic resistance of Helicobacter pylori in pediatric patients -- 10 years' experience. aug: au: Hojsak I Kos T Dumancic J Misak Z Jadresin O Jaklin Kekez A Lukic Grlic A Kolacek S Hojsak, Iva Kos, Tea Dumančić, Jelena Mišak, Zrinjka Jadrešin, Oleg Jaklin Kekez, Alemka Lukić Grlić, Amarela Kolaček, Sanja affil: Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University of Zagreb Medical School, Klaićeva 16, Zagreb, Croatia sug: subj: Amoxicillin Therapeutic Use Antibiotics Therapeutic Use Clarithromycin Therapeutic Use Drug Resistance, Microbial Helicobacter Infections Drug Therapy Helicobacter Pylori Drug Effects Metronidazole Therapeutic Use Adolescence Amoxicillin Pharmacodynamics Antibiotics Pharmacodynamics Biopsy Child Child, Preschool Clarithromycin Pharmacodynamics Croatia Drug Therapy, Combination Female Gastroscopy Helicobacter Infections Microbiology Helicobacter Infections Pathology Helicobacter Pylori Human Infant Male Metronidazole Pharmacodynamics Microbial Culture and Sensitivity Tests Proton Pump Inhibitors Therapeutic Use Retrospective Design Treatment Outcomes Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Female Male ab: The aim of this study was to assess the pattern of evolution of resistance to antibiotics in Helicobacter pylori isolated from children who underwent upper endoscopy with antral biopsy during a 10-year period (2001-2010). We retrospectively analyzed data of all children (n = 3,008) who underwent upper endoscopy during the observed period at the Children's Hospital Zagreb, a university tertiary medical center. We calculated the rate, antibiotic susceptibility and risk factors for the H. pylori infection in our cohort. Antral biopsy was performed in 2,313 (76.89%) patients. Altogether, 382 (16.51%) children had positive biopsy for H. pylori (histology and/or culture). There was no significant difference in the incidence of H. pylori during 10 years of observation (p = 0.21). Infected children compared to non-infected group were older (p = 0.005), and had more often antral nodularity (p < 0.0001), and duodenal ulcer (p = 0.002). Altogether, 22.4% of treatment-naïve patients had strains resistant to tested antibiotics: majority to azithromycin (17.9%), followed by clarithromycin (11.9%), metronidazole (10.1%) and amoxicillin (0.6%). In the eradication failure group, 9/11 of children had strains resistant to tested antibiotics, mostly to metronidazole (7/11), followed by azithromycin (3/11) and clarithromycin (1/11). No correlation was found between age or gender and antibiotic resistance (p = 0.32, for both). In conclusion, our data strongly support current guidelines which recommend antibiotic susceptibility testing prior to eradication therapy. Based on our results we recommend the use of amoxicillin-metronidazole-based regimen as the first-line therapy in our study population. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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