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Eradication Treatment of Helicobacter pylori Infection Based on Molecular Pathologic Antibiotic Resistance

Authors Gao C, Du SY, Fang L, Fan YH, Song AP, Chen H

Received 23 September 2019

Accepted for publication 17 December 2019

Published 7 January 2020 Volume 2020:13 Pages 69—79

DOI https://doi.org/10.2147/IDR.S232169

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Sahil Khanna


Chun Gao, 1 Shi-Yu Du, 1 Long Fang, 1 Yan-Hua Fan, 1 Ai-Ping Song, 2 Huang Chen 2

1Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, People’s Republic of China; 2Department of Pathology, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, People’s Republic of China

Correspondence: Yan-Hua Fan
Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, No. 2 Yinghua East Road, Beijing 100029, People’s Republic of China
Tel/Fax +86-10-84205503
Email fanyanhua@zryhyy.com.cn

Background: Unfortunately, the eradication rate of Helicobacter pylori (H. pylori) treatment is markedly decreasing in recent years and the major reason is antibiotic resistance. Our study was designed to determine the effect and safety of H. pylori eradication treatment based on the molecular pathologic antibiotic resistance.
Methods: 261 patients were analyzed retrospectively, including 111 patients who were treated for the first time (one group as First-treated) and 150 patients who failed at least once in bismuth quadruple therapy (another group as Re-treatment). Antibiotic resistance was examined by Real-time PCR detection and conventional PCR and sequencing method. The eradication rate (ER) was compared per intention to treat (ITT) and per protocol (PP) between the two groups.
Results: The resistance rates to amoxicillin, clarithromycin, fluoroquinolone and tetracycline were 5.5%, 42.1%, 41.7% and 12.9% in the 111 first-treated patients, and 11.7%, 79.7%, 70.7% and 30.0% in the 150 re-treatment patients. The ERs in the ITT and PP analyses were 92.79% (95% CI, 87.98– 97.60%, n=111) and 98.10% (95% CI, 95.48– 100%, n=105), respectively, in the first-treated patients and 90.67% (95% CI, 86.01– 95.32%, n=150) and 95.10% (95% CI, 91.57– 98.64%, n=143), respectively, in the re-treatment patients. No significant differences were shown in the ERs between two group patients, and no serious adverse events were found.
Conclusion: H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in both first and re-treated patients.

Keywords: Helicobacter pylori, antibiotic resistance, eradication, first treatment, re-treatment, molecular pathology
 

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