Efficacy of tailored therapy for Helicobacter pylori eradication based on clarithromycin resistance and survey of previous antibiotic exposure: A single‐center prospective pilot study
| Autor: | Su Youn Nam, Ji Hey Park, Yong Hwan Kwon, Hyun Suk Lee, Seong Woo Jeon |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Antibiotics Pilot Projects Subgroup analysis Single Center Gastroenterology Helicobacter Infections 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Clarithromycin Metronidazole Internal medicine Drug Resistance Bacterial Multiplex polymerase chain reaction Humans Medicine Prospective Studies Disease Eradication Aged Helicobacter pylori biology business.industry Amoxicillin General Medicine Middle Aged biology.organism_classification Anti-Bacterial Agents Infectious Diseases 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Helicobacter. :e12585 |
| ISSN: | 1523-5378 1083-4389 |
| Popis: | Background As the prevalence of antibiotic resistance is increasing, the effectiveness of traditional Helicobacter pylori (H pylori) therapies is gradually declining. We aimed to evaluate the efficacy of tailored therapy (dual priming oligonucleotide [DPO]-based multiplex PCR) and previous antibiotic exposure survey predicting for antibiotic resistance. Materials and methods Patients with H pylori infection who did not receive previous treatment were enrolled. The patients were divided into four groups (no resistance [NR] group, clarithromycin resistance [CLA-R] group, metronidazole-resistant [MET-R] group, and CLA- and MET-resistant [Dual-R] group) based on the results of dual priming oligonucleotide (DPO) polymerase chain reaction (PCR) and previous antibiotic exposure survey, and they were treated with tailored therapy based on antibiotic susceptibility. Results Consecutive patients were distributed in the NR (n = 36, 70.6%), CLA-R (n = 9, 17.6%), and suspected MET-R (n = 6, 11.8%) group. The overall intention-to-treat/per-protocol eradication rate (ITT/PP) was 92.2%/94.0%. In the subgroup analysis, the ITT and PP of the NR, CLA-R, and MET-R groups were 94.4%/94.4%, 77.8%/87.5%, and 100.0%/100.0%, respectively. Total of 31 patients in all subgroups were evaluated for antibiotic resistance; five (16.1%), two (6.5%), and three (9.7%) participants showed CLA, MET, and dual resistance in culture-based susceptibility test. Compared with culture-based MIC test, the accuracy of DPO-based multiplex PCR in determining CLA resistance was 90.3%, while the accuracy of survey in determining MET resistance was only 77.4%. Conclusion A tailored therapy based on DPO-PCR and history of previous antibiotic use is useful in clinical practice and well correlated with culture-based susceptibility test. |
| Databáze: | OpenAIRE |
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