Relevance of antibiotic sensitivities in predicting failure of omeprazole, clarithromycin, and tinidazole to eradicate Helicobacter pylori.
Omeprazole 20 mg once (o.d.) or twice daily (b.d.), clarithromycin 250 mg b.d., and tinidazole 500 mg b.d. for 7 days (OCT) is an effective regimen against Helicobacter pylori, but the effect of 5-nitroimidazole resistance is unclear. We aimed to evaluate this using the disc diffusion technique (Mas...
| Publicado en: | Journal of Gastroenterology Vol. 33; no. 2; pp. 160 - 164 |
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| Autores principales: | , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
1998
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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=4689852&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 4689852 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09441174 EJ7 jtl: Journal of Gastroenterology issn: 09441174 maglogo: N pubinfo: dt: 1998 vid: 33 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 4689852 4689852 NLM9605943 4689852 10.1007/s005350050064 NLM9605943 4689852 ppf: 160 ppct: 4 formats: tig: atl: Relevance of antibiotic sensitivities in predicting failure of omeprazole, clarithromycin, and tinidazole to eradicate Helicobacter pylori. aug: au: Moayyedi, Paul Ragunathan, P. L. Mapstone, Nic Axon, Anthony T. R. Tompkins, David S. Moayyedi, P Mapstone, N Axon, A T Tompkins, D S affil: Gastroenterology Department, Centre for Digestive Diseases, General Infirmary at Leeds, United Kingdom sug: subj: Antibiotics Therapeutic Use Imidazoles Therapeutic Use Omeprazole Therapeutic Use Gastrointestinal Agents Therapeutic Use Helicobacter Infections Drug Therapy Imidazoles Pharmacodynamics Helicobacter Pylori Drug Effects Clarithromycin Therapeutic Use Drug Resistance, Microbial Gastrointestinal Agents Administration and Dosage Imidazoles Administration and Dosage Clarithromycin Administration and Dosage Aged Female Human Adult Antibiotics Administration and Dosage Treatment Failure Omeprazole Administration and Dosage Middle Age Male Validation Studies Comparative Studies Evaluation Research Multicenter Studies Interview Guides Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Omeprazole 20 mg once (o.d.) or twice daily (b.d.), clarithromycin 250 mg b.d., and tinidazole 500 mg b.d. for 7 days (OCT) is an effective regimen against Helicobacter pylori, but the effect of 5-nitroimidazole resistance is unclear. We aimed to evaluate this using the disc diffusion technique (Mast Diagnostics, Bootle, UK) and E-test (Cambridge Diagnostics Services, Cambridge, UK) to assess 5-nitroimidazole resistance. H. pylori was cultured from antral biopsies of infected patients, as determined by 13C-urea breath test (13C-UBT), histology, and/or rapid urease test. Patients were prescribed OCT and H. pylori eradication was assessed by 13C-UBT at least 4 weeks after completion of therapy. Antibiotic sensitivities to metronidazole and clarithromycin were evaluated by the disc diffusion method and by the measurement of minimum inhibitory concentration (MIC) using the E-test. One hundred and forty-one H. pylori-infected patients were enrolled in the study and the organism was successfully cultured from 119 patients (84%). The overall eradication rate was 125/141 (89%). OCT was successful in 62/69 (90%) patients harboring fully sensitive strains of H. pylori, compared with 42/45 (93%) of patients with strains that were resistant to metronidazole alone (P = 0.74, Fisher's exact test). MIC was assessed in 22 samples. Using a cut-off point of >32 microg/ml to define metronidazole resistance eradication rates were higher against sensitive (9/12; 75%) than resistant (3/10; 30%) strains (P = 0.08, Fisher's exact test). 5-Nitroimidazole resistance assessed by the disc diffusion technique is not helpful in predicting OCT failure, but the E-test may be of value. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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