Antibiotics resistance ofHelicobacter pyloriand treatment modalities in children withH. pyloriinfection

Abstract

Pediatric infection with Helicobacter pylori may occur early in childhood and persist lifelong. Global pediatric clinical studies have reported a decreasing tendency in the overall rate of H. pylori eradication. In pediatric patients with H. pylori infection, pediatric patients with peptic ulcer, and the first-degree relatives of patients with a history of gastric cancer, it is commonly recommended that H. pylori strains be eradicated. Antibiotic drug resistance to H. pylori, which has been reported to vary widely between geographic regions, is mainly associated with treatment failure in these patients. It is therefore imperative that the antibiotic resistance rates of H. pylori in children and adolescents be meticulously monitored across countries and throughout geographic regions. This paper particularly focuses on the antibiotic drug resistance of H. pylori and the thearpy of pediatric H. pylori infection cases.

Helicobacter pylori Eradication in Patients with Immune Thrombocytopenic Purpura: A Review and the Role of Biogeography

“…The addition of various probiotic compound supplements, containing Lactobacillus , Bifidobacterium , Saccharomyces , and other bacteria, have also been implicated in both reducing the adverse effects of eradication treatment and improving eradication rates, although studies supporting this are contradictory [98]. The antibiotics chosen may vary by region due to the emergence of H. pylori antibiotic resistance in highly endemic areas [99,100]. This rise in antimicrobial resistance, particularly against clarithromycin and metronidazole, combined with poor patient compliance, has resulted in a <70% eradiation rate in most countries [101,102].…”

Increasing metronidazole and rifampicin resistance of Helicobacter pylori isolates obtained from children and adolescents between 2002 and 2015 in southwest Germany

“…As also observed for other bacterial pathogens, one major problem is the emerging antibiotic resistance of H. pylori particularly to clarithromycin . The resistance to clarithromycin is due to mutations in the 23S rRNA gene of H. pylori , and these can be detected by PCR or fluorescent in situ hybridization (FISH) in gastric biopsy specimens .…”

Detection of A2143G, A2142C, and A2142G Point Mutations with Real-Time PCR in Stool Specimens from Children Infected with Helicobacter pylori

“…The type of mutation is not the same for every country. The A2144G mutation is most common in clarithromycin-resistant H. pylori strains in South Korea and Japan [ 4 ]. Clarithromycin resistance is likely caused by the use of macrolides in pediatric, respiratory, and otorhinolaryngology infections [ 44 ].…”

“…Information in the literature related to the antimicrobial susceptibility of H. pylori in children is limited because endoscopy is rarely indicated; therefore, culture and antimicrobial susceptibility tests are rarely performed [ 4 ]. According to the Maastricht IV Consensus, idiopathic thrombocytopenic purpura and iron deficiency anemia are extragastric disorders for which H. pylori infection detection and eradication are indicated, while diagnostic tests are recommended in pediatric patients with peptic ulcer disease in the guidelines of both the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) and the North American Society for Paediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) [ 5 , 6 ].…”

“…Increases in clarithromycin resistance rates in children may be due to the excessive use of clarithromycin for the treatment of respiratory tract infections. Clarithromycin resistance in H. pylori can cause treatment failure in triple therapy (proton pump inhibitor in combination with two antibiotics, including amoxicillin, clarithromycin, or metronidazole) [ 3 , 4 ].…”