engleski

Impact of metronidazole primary resistance on H. Pylori eradication

Background: In the quest for better anti-H. Pylori therapy the effect of antimicrobial resistance is worth to consider. Aim: To assess the H. Pylori eradication rates of two different 7-day triple therapies in relation to metronidazole resistance. Methods: The study encompassed 187 trials of H. Pylori eradication in patients with peptic ulcer disease either by a) 7-day triple therapy of amoxicilline (A) 1 g bid, metronidazole (M) 500 mg bid with pantoprozole 40 mg bid or omeprazole or 20 mg bid (N = 150) or by b) 7-day metronidazole 500 mg bid, azithromycine (Az) 1 g od for 3 dyas with pantoprazole 40 mg bid or omeprazole 20 mg bid (N = 37). H. Pylori status was assessed by histology, CLO test, culture of antral and corpus biopsies and by 13C urea Breath Test (UBT). Repeat endoscopy was performed at least 28 days after the last does of study medication. Cure of H. Pylori infection was assumed if all tests were negative. Resistance was determined by E-test. Strains were considered M-resistant if MIC was >16 m. Results: H. Pylori cure Total (%) M-sensitive M-resistant a) PPI-A-M (n = 150) 100 (66.67) 83 (72.81) 17 (47.22) b) PPI-Az-M (n = 37) 26 (70.27) 18 (72.0) 8 (57.14) Conclusion: In the case of pretreatment metronidazole resistance the efficacy of two triple anti-H. Pylori therapies containing metronidazole with PPI and amoxicilline or azithromycine did not differ significantly reaching 47% and 57% eradication rate, respectively.

Helicobacter pylori; terapija; metronidazol; rezistencija; eradikacija

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