Antibiotic Resistance and Therapy Outcome in H. pylori Eradication Failure Patients
| Autor: | Giulia Fiorini, Matteo Pavoni, Tiziana Lazzarotto, Ilaria Maria Saracino, Guido Antonelli, Dino Vaira, R Cavallo, Laura Saccomanno, A. Zullo |
|---|---|
| Přispěvatelé: | Saracino IM*., Pavoni M*., Zullo A., Fiorini G., Saccomanno L., Lazzarotto T., Cavallo R., Antonelli G., Vaira D |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty antibiotic resistance medicine.drug_class Antibiotics Biochemistry Microbiology H. pylori 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Levofloxacin Internal medicine Clarithromycin medicine Pharmacology (medical) In patient General Pharmacology Toxicology and Pharmaceutics Therapy Outcome biology business.industry non-naïve patient antibiotic susceptibility test lcsh:RM1-950 Helicobacter pylori rescue therapies biology.organism_classification Metronidazole 030104 developmental biology Infectious Diseases lcsh:Therapeutics. Pharmacology non- naïve patients 030211 gastroenterology & hepatology non-naïve patients business medicine.drug |
| Zdroj: | Antibiotics Volume 9 Issue 3 Antibiotics, Vol 9, Iss 3, p 121 (2020) |
| ISSN: | 2079-6382 |
| DOI: | 10.3390/antibiotics9030121 |
| Popis: | Helicobacter pylori (H. pylori) eradication fails in a definite amount of patients despite one or more therapeutic attempts. Curing these patients is progressively more difficult, due to development of antibiotic resistance. Current guidelines suggest testing antibiotic susceptibility in H. pylori isolates following two therapeutic attempts. Aim: to evaluate the development of antibiotic resistance, MIC values trends and therapeutic outcomes in patients who failed at least one H. pylori eradication therapy. Methods: consecutive patients, referred to perform upper gastrointestinal endoscopy (UGIE) to our Unit from January 2009 to January 2019 following at least one therapeutic attempt were considered. Bacterial resistance towards clarithromycin, metronidazole and levofloxacin was tested. Patients received either a susceptibility-guided therapy or Pylera® Results: a total of 1223 patients were H. pylori positive, and antibiotic susceptibility was available for 1037. The rate of antibiotic resistance and MIC values significantly increased paralleling the number of previous therapeutic attempts. Eradication rates of antibiogram-tailored therapies remained stable, except for the sequential therapy if used as a third line. As a rescue treatment, the Pylera® therapy achieved cure rates comparable to those of the other culture-guided therapies. Conclusions: A significant increase in the secondary resistance towards the three tested antibiotics was observed, both as rate and MIC values, in correlation with the number of therapy failures. These findings should be considered when administering an empirical second-line therapy. Pylera® therapy eradication rates are comparable to culture-tailored therapies. |
| Databáze: | OpenAIRE |
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