While the development of antibacterial resistance has broad implications, in gastroenterology patients specific problems have emerged with Helicobacter pylori (H pylori) and this has led to changes in first-line therapy( ). More data on the treatment resistant H pylori has been published (JPGN 2013; 56: 645-48).
77 consecutive strains of H pylori from Brazilian children and adolescents were isolated from gastric biopsies and analyzed; this study took place between 2008-2009 and the mean age was 11.1 years. In 71 strains, there were no previous attempts at eradication.
- 40% of strains were resistant to metronidazole
- 19.5% of strains were resistant to clarithromycin
- 10.4% of strains were resistant to amoxicillin
- All strains were susceptible to furazolidone and tetracycline
- 14/77 (18.2%) patients had multiple resistances
Take-home point: Resistance to antibiotics is altering our approach to H pylori therapy. Antibiotic susceptibility testing may be needed to improve antibiotic selection and eradication rates.
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