ObjectiveTo describe antibiotic resistance patterns in Helicobacter pylori.
DesignCulture and antibiotic sensitivity testing of antral and gastric body biopsy samples from patients having gastroscopy.
ParticipantsConsecutive consenting patients aged 18 years or more presenting for gastroscopy from 1 July 1998 to 30 June 1999.
SettingAn open‐access gastroscopy service at an urban university tertiary hospital.
Main outcome measuresNumber of H. pylori isolates showing resistance to antibiotics; correlates of such resistance with demographic and clinical information.
ResultsOf 1580 patients undergoing endoscopy, 434 agreed to participate in the study. 108 (24.9%) had positive cultures for H. pylori, and 88 of these isolates (81%) were available for further testing. Resistance to metronidazole and clarithromycin was detected in 36% and 11%, respectively. No resistance was found to tetracycline or amoxycillin. Metronidazole resistance was commoner in younger patients (P = 0.0004) and macrolide resistance was commoner in those born outside Australia or New Zealand (P = 0.03).
ConclusionsWe found substantial resistance to metronidazole, and emerging clarithromycin resistance, but complete susceptibility to amoxycillin, tetracycline, gentamicin and cefaclor. These factors may influence the effectiveness of presently recommended eradication regimens.
Since July 1988 all eight general surgeons at Fremantle Hospital have used a computer‐based surgical audit and discharge system. At the time of writing (September 1991) 10919 computer‐generated discharge letters have been produced by the system.
This paper describes the system and reports a series of quality control assessments carried out between 1 July 1988 and 30 June 1990 during which 30 pre‐registration surgical residents completed 5716 data collection forms. It was found that:
(1) data collection for 23 of 24 monthly surgical audits was at least 95% complete;
(2) outstanding surgical discharge summaries were reduced by 89%;
(3) the residents recorded 17/19 wound infections and identified 15 (79%) of these as a surgical complication; and
(4) the residents tended to under‐record complications in patients who had more than one complication during their hospital stay.
It was concluded that the system was robust, and that resident staff collected data in such a way that good quality computer‐generated discharge letters were produced in a timely manner. Closer attention to aspects of data collection will be required before the optimum surgical audits of the QX system can be generated.
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