Gut 1998;43(Suppl 1):S61-S65 ( July )

Clinical relevance of resistant strains of Helicobacter pylori: a review of current data

F Mégraud, H P Doermann

Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux, France

Correspondence to: Professor Mégraud.

The first 150 words of the full text of this article appear below.

	Summary

Acquired resistance of Helicobacter pylori to metronidazole and clarithromycin has been reported, with metronidazole resistance being very common. This has an important clinical impact on dual therapies, as well as on the standard triple therapies. However, when antisecretory drug based triple therapies with amoxycillin or clarithromycin and metronidazole are used, the resistance can be overcome in up to 75% of the cases in most of the studies. Clarithromycin seems to be a better choice than amoxycillin to achieve this goal. Nevertheless, resistance to metronidazole remains a risk factor for treatment failure.

The most precise information comes from studies in which minimum inhibitory concentrations (MICs) are reported as well as whether the strain is susceptible or resistant.

Few data are available from clinical trials to measure the impact of clarithromycin resistance. However, such resistance seems to have a negative impact on the clinical outcome of treatment.

It is of great importance . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Megraud, F (2004). H pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut 53: 1374-1384 [Full Text]  
• Scarpellini, P., Carrera, P., Cavallero, A., Cernuschi, M., Mezzi, G., Testoni, P. A., Zingale, A., Lazzarin, A. (2002). Direct Detection of Helicobacter pylori Mutations Associated with Macrolide Resistance in Gastric Biopsy Material Taken from Human Immunodeficiency Virus-Infected Subjects. J. Clin. Microbiol. 40: 2234-2237 [Abstract] [Full Text]  
• Chisholm, S. A., Owen, R. J., Teare, E. L., Saverymuttu, S. (2001). PCR-Based Diagnosis of Helicobacter pylori Infection and Real-Time Determination of Clarithromycin Resistance Directly from Human Gastric Biopsy Samples. J. Clin. Microbiol. 39: 1217-1220 [Abstract] [Full Text]  
• Jenks, P. J., Ferrero, R. L., Tankovic, J., Thiberge, J.-M., Labigne, A. (2000). Evaluation of Nitrofurantoin Combination Therapy of Metronidazole-Sensitive and -Resistant Helicobacter pylori Infections in Mice. Antimicrob. Agents Chemother. 44: 2623-2629 [Abstract] [Full Text]  
• O'Gara, E. A., Hill, D. J., Maslin, D. J. (2000). Activities of Garlic Oil, Garlic Powder, and Their Diallyl Constituents against Helicobacter pylori. Appl. Environ. Microbiol. 66: 2269-2273 [Abstract] [Full Text]  
• Mégraud, F., Lehn, N., Lind, T., Bayerdörffer, E., O'Morain, C., Spiller, R., Unge, P., van Zanten, S. V., Wrangstadh, M., Burman, C. F. (1999). Antimicrobial Susceptibility Testing of Helicobacter pylori in a Large Multicenter Trial: the MACH 2 Study. Antimicrob. Agents Chemother. 43: 2747-2752 [Abstract] [Full Text]  
• Samuelson, J. (1999). Why Metronidazole Is Active against both Bacteria and Parasites. Antimicrob. Agents Chemother. 43: 1533-1541 [Full Text]  
• Jenks, P. J., Labigne, A., Ferrero, R. L. (1999). Exposure to Metronidazole In Vivo Readily Induces Resistance in Helicobacter pylori and Reduces the Efficacy of Eradication Therapy in Mice. Antimicrob. Agents Chemother. 43: 777-781 [Abstract] [Full Text]  
• Mégraud, F., Occhialini, A., Rossignol, J. F. (1998). Nitazoxanide, a Potential Drug for Eradication of Helicobacter pylori with No Cross-Resistance to Metronidazole. Antimicrob. Agents Chemother. 42: 2836-2840 [Abstract] [Full Text]