H pylori antibiotic resistance: prevalence, importance, and advances in testing

Mégraud, Françis

doi:10.1136/gut.2003.022111

Cited by 840 publications

(967 citation statements)

References 143 publications

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“…H pylori is becoming increasingly resistant to antibiotics [9,10] , but the prevalence of resistance to amoxicillin is rare, occurring between 0 and 1%, and has not increased over time. Thus, this antibiotic is an essential eradication regimen in clinical practice [9,11] .…”

Section: Introductionmentioning

confidence: 99%

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Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Zheng

Bao

et al. 2010

Acta Pharmacol Sin

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Aim: To investigate the distribution of amoxicillin in the gastric juice and gastric mucosa of rats and to investigate the effects of proton pump inhibitor rabeprazole on amoxicillin concentrations in various compartments. Methods: One hundred and sixty anesthetized rats were divided into five groups, and given intravenously different doses of amoxicillin or amoxicillin and rabeprazole. The pH value and volume of gastric juice was aspirated were measured and separated gastric mucosa was homogenized. The concentrations of amoxicillin in the plasma, gastric juice and gastric mucosa were measured by high performance liquid chromatography (HPLC). Results: The maximum concentrations of amoxicillin in gastric juice and gastric mucosa were significantly lower than those in plasma (P<0.001). Concentrations in the glandular stomach mucosa were higher than those in the forestomach mucosa. Rabeprazole did not significantly change the pharmacokinetic parameters of amoxicillin in the plasma and did not alter gastric antibiotic clearance or the gastric transfer fraction of amoxicillin in gastric juice. However, rabeprazole did increase the amoxicillin concentration and pH value in gastric juice and reduced the volume of the gastric juice. Conclusion: Amoxicillin could penetrate the gastric mucosa and achieve therapeutic concentrations at the target site after transfer from the blood to the stomach. Rabeprazole increased the amoxicillin concentration in gastric juice by decreasing the gastric juice volume but did not affect its concentration in blood or gastric mucosa.

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Section: Introductionmentioning

confidence: 99%

“…Thus, this antibiotic is an essential eradication regimen in clinical practice [9,11] . Rabeprazole, a proton pump inhibitor, has been used for the treatment of H pylori due to its many advantages, including the fact that its pharmacokinetics and pharmacodynamics are not influenced by CYP2C19 genetic polymorphisms [12] .…”

Section: Introductionmentioning

confidence: 99%

Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Zheng

Bao

et al. 2010

Acta Pharmacol Sin

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“…7 The most frequent of these are transitions of adenine to guanine at the 2143 or 2142 positions, which account for 480% of clarithromycin resistance seen worldwide and B90% of resistance seen in developed countries. 8 A variety of diagnostic methods have been developed for H. pylori, including culture and histopathology, rapid urease tests, stool antigen testing, the urea breath test, serology, and more recently molecular assays. 3,9 Of these, culture is the only widely available method that also allows for antimicrobial susceptibility testing.…”

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confidence: 99%

PCR detection of clarithromycin-susceptible and -resistant Helicobacter pylori from formalin-fixed, paraffin-embedded gastric biopsies

et al. 2013

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Antimicrobial resistance to clarithromycin is a growing concern in the treatment of Helicobacter pylori and is associated with three major point mutations of the 23S rRNA, A2142C, A2142G, and A2143G. The use of traditional culture-based methods for determination of clarithromycin resistance in H. pylori are time consuming and lack sensitivity. We implemented a real-time PCR with melt curve analysis to detect and characterize H. pylori in formalin-fixed, paraffin-embedded gastric biopsy specimens to assess the frequency of clarithromycin resistance mutations in our study population. One hundred and fifty-three formalin-fixed, paraffin-embedded gastric biopsies were chosen on the basis of positive immunohistochemical staining for H. pylori and an accompanying histopathological diagnosis of Helicobacter-associated gastritis. New adjacent sections were taken for immunohistochemical staining and DNA extraction with subsequent testing by PCR assay and melt curve analysis using a primer and probe combination first described by Oleastro et al. 12 One hundred and forty-six samples demonstrated adequate amplification of a human DNA control target. Of these, there were 122 H. pylori immunohistochemistry-positive samples. In all, 103 out of 122 (84%) immunohistochemistry-positive samples demonstrated amplifiable H. pylori 23S rRNA gene target and 19 (16%) demonstrated no amplification of H. pylori. Twenty-two samples were negative for H. pylori by immunohistochemistry and PCR. Two were negative for H. pylori by immunohistochemistry, but were positive for H. pylori by PCR. In all, 52 out of 105 (50%) PCR-positive samples demonstrated resistance mutations, and it was determined that a heterogeneous population of mutated and unmutated organisms was present in 11 out of 52 samples. The use of PCR assays allows for a timely assessment of clarithromycin resistance status without the disadvantages of culture-based methods, and may lead to a decrease in treatment failure rates.

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“…La resistencia a Cla observada en el grupo en estudio corresponde a una tasa de 20,0% (Tabla 1), valor bastante mayor al 2,0% encontrado previamente en la VIII región 15 . Si bien los datos de la literatura muestran que la resistencia a Cla puede alcanzar hasta 50,0% 20,32,33 , no está del todo clara la causa de esta variación entre las diferentes poblaciones y regiones, pudiendo en nuestro medio encontrarse explicación en el efecto mutagénico de Mtz 34 , al ser éste un medicamento de amplio uso. Otro factor de riesgo para la resistencia a Cla es el consumo previo de macróli-dos, derivado de un aumento en la prescripción de estas drogas.…”

Section: Discussionunclassified

“…Se ha informado que, en algunos países, la resistencia a Tet es muy baja, 0,7% en España, 0,5% en el Reino Unido y 0,5% en Hong Kong, aunque también se ha observado una elevada tasa en Corea, 5,3% 12,20,33 . Nuestros datos muestran que la resistencia primaria adquirida a Tet alcanzó 26,8% en el grupo en estudio (Tabla 1).…”

Section: Discussionunclassified

Prevalencia de la resistencia a metrodinazol, claritromicina y tetraciclina en Helicobacter pylori aislado de pacientes de la Región Metropolitana

et al. 2007

Rev. méd. Chile

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H pylori antibiotic resistance: prevalence, importance, and advances in testing

Cited by 840 publications

References 143 publications

Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole

PCR detection of clarithromycin-susceptible and -resistant Helicobacter pylori from formalin-fixed, paraffin-embedded gastric biopsies

Prevalencia de la resistencia a metrodinazol, claritromicina y tetraciclina en Helicobacter pylori aislado de pacientes de la Región Metropolitana

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