Retrospective study on outcome of salvage Helicobacter pylori eradication therapies based on molecular genetic susceptibility testing
| Autor: | Manfred Kist, Benjamin Blümel, Hanna Goelz, Erik-Oliver Glocker |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Adolescent Urea breath test 030106 microbiology Levofloxacin Microbial Sensitivity Tests Helicobacter Infections Young Adult 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Clarithromycin Internal medicine Drug Resistance Bacterial Genetic predisposition medicine Humans Helicobacter Aged Retrospective Studies Aged 80 and over Salvage Therapy Helicobacter pylori biology medicine.diagnostic_test business.industry Gastroenterology Retrospective cohort study General Medicine Middle Aged biology.organism_classification Anti-Bacterial Agents Treatment Outcome Infectious Diseases Mutation Female 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Helicobacter. 23:e12494 |
| ISSN: | 1083-4389 |
| Popis: | BACKGROUND Antimicrobial susceptibility of Helicobacter (H.) pylori is usually determined by phenotypic methods. When H. pylori cannot be grown owing to contaminations or delay in transport of gastric tissue samples to the microbiological laboratory, molecular genetic testing is a reasonable alternative. The aim of this retrospective study was to assess the outcome of salvage eradication treatments based on molecular genetic susceptibility testing. METHODS Data on 144 H. pylori PCR-positive gastric tissue samples of patients primarily with prior unsuccessful eradication treatments were retrospectively analyzed. Eradication treatments were recommended based on genotypic clarithromycin and/or levofloxacin susceptibility as tested by real-time PCR or reverse hybridization. Treatment success was assessed by attending physicians using urea breath test; stool-antigen ELISA; and microbiology/histopathology. RESULTS Overall success rate of molecular genetic testing-guided salvage treatments was low (68%); none of the regimens chosen was significantly better than another. Multivariable logistic regression analysis did not reveal any factors that may predict treatment failure. CONCLUSIONS Eradication success was poor despite susceptibility testing. Gastroenterologists are advised to prescribe recommended salvage treatments, considering recommended dosages and prolonged treatment duration. |
| Databáze: | OpenAIRE |
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