LOW-RATE OF EMERGENCE OF CLARITHROMYCIN-RESISTANT HELICOBACTER-PYLORIWITH AMOXICILLIN CO-THERAPY

Citation
L. Laine et al., LOW-RATE OF EMERGENCE OF CLARITHROMYCIN-RESISTANT HELICOBACTER-PYLORIWITH AMOXICILLIN CO-THERAPY, Alimentary pharmacology & therapeutics, 12(9), 1998, pp. 887-892
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology & Pharmacy","Gastroenterology & Hepatology
ISSN journal
0269-2813
Volume
12
Issue
9
Year of publication
1998
Pages
887 - 892
Database
ISI
SICI code
0269-2813(1998)12:9<887:LOEOCH>2.0.ZU;2-K
Abstract
Background: Patients with persistent Helicobacter pylori infection fol lowing treatment with clarithromycin or omeprazole plus clarithromycin often develop clarithromycin resistance, Aim: To assess pre- and post -treatment antibiotic resistance in three double-blind trials of tripl e therapy with omeprazole, amoxycillin and clarithromycin.Methods: Pat ients with H. pylori and duodenal ulcer (studies 1 and 2) or history o f duodenal ulcer (study 3) were randomly assigned to 10 day courses of omeprazole 20 mg b.d., amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. (OAC) or placebo, amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. (AC), Endoscopy was performed at baseline and 4 weeks after comp letion of therapy in studies 1 and 2, and at 4-6 weeks after therapy i n study 3. At baseline, H. pylori was diagnosed by CLO test with confi rmation by histology, or by culture. Eradication was defined as no pos itive biopsy test and greater than or equal to 2 negative tests. Susce ptibility testing was performed using the Etest. Results: In the 91 pa tients with pre-treatment susceptible isolates who had persistent infe ction after AC, 10 developed resistance, eight had intermediate suscep tibility and 73 continued to have clarithromycin-susceptible H. pylori isolates. In the 10 patients with pre-treatment susceptible isolates who had persistent infection after OAC, three developed clarithromycin resistance and seven still had susceptible isolates. Conclusions: Use of amoxycillin co-therapy results in a low rate of clarithromycin res istance developing in patients with persistent H. pylori infection fol lowing therapy with a clarithromycin-containing regimen.