Helicobacter pylori: antibiotic resistance and eradication rates in Suffolk, UK, 1991–2001

Abstract

Helicobacter pylori infection causes a number of gastrointestinal diseases and its current treatment is based on multidrug regimes including acid suppression and antimicrobials. The success of these regimes is determined by a number of factors including antibiotic resistance, which varies widely but is an increasing problem. Local data are important in establishing the most cost-effective eradication regime. Data have been collected prospectively on antibiotic resistance at Ipswich Hospital (Suffolk, UK) in all consecutive isolates of H. pylori from 1991 to 2001. The success of regimes consisting of a proton pump inhibitor, amoxycillin and metronidazole (PPI/A/M) has also been evaluated in patients found positive on serological testing in primary care using urea breath testing. Overall, metronidazole resistance was found in 31. 7 % of isolates and clarithromycin resistance in 5. 3 %. A significant increase in metronidazole resistance from 29. 1 to 37. 0 % (P ¼ 0. 022) and a decrease in clarithromycin resistance from 10. 3 to 3. 8 % (P ¼ 0. 014) was seen over the study period. Metronidazole resistance was significantly more common in women (P , 0. 001) and young patients (P , 0. 001). Eradication with PPI/A/M was successful in 89. 9 % of patients and did not change significantly over the study period. Eradication rates were lower in young patients (P , 0. 001). Whilst metronidazole resistance is increasing in Suffolk, this does not seem to have a significant effect on eradication rates. Metronidazole-based regimes are still effective first-line treatments in most patients. †Present address:

Update on Clarithromycin Resistance in <i>Helicobacter pylori</i> in Hong Kong and Its Effect on Clarithromycin-Based Triple Therapy

“…The prevalence of clarithromycin resistance falls within the data reported worldwide, including China (10%) [17], Japan (11%) [18], the USA (10.1%) [19], Germany (2.2%) [20], and the UK (5.3%) [21]. Recently, a few studies reported that the resistant rates to clarithromycin were 3% in the USA [22], 15% in Poland [23], and 26.7% in Italy [24], probably in the same period of time as our study.…”

Curcumin Alleviates Matrix Metalloproteinase-3 and -9 Activities during Eradication of Helicobacter pylori Infection in Cultured Cells and Mice

“…The similarity in the outcome of TT and only-antibiotics treatments clearly indicated that the effect of TT on these MMPs and TIMPs was entirely because of Hp eradication while curcumin was effective in both Hp eradication and biochemical regulation of these MMPs that synergistically influenced good quality healing and tissue restitution. These findings raised an important question, whether curcumin may be considered as an alternative therapy against Hp-infection since TT has considerable complications and side effects on patients [4], [5].…”

“…However, such multiple therapy regimens have not been very successful in clinical practice, since the overuse or rather misuse of antibacterial agents have resulted in the emergence of antibiotic-resistant strains which is the prime cause of treatment failure apart from potential side effects [4], [5]. Increasing complications in the conventional triple-therapy (TT) stimulate an urgent need to develop new non-antibiotic antibacterial agents against Hp-infection that are safe, highly effective and have specific cellular targets.…”

Relationship between Helicobacter pylori detection and an increased risk of infection in childhood

“…Helicobacter pylori is involved in the pathogenesis of a number of gastrointestinal diseases, including acute and chronic gastritis, peptic ulceration, gastric carcinoma and gastric lymphoma (1,2). The risk of developing gastric cancer is believed to be related to differences among H. pylori strains and the inflammatory responses mediated by host genetic factors (3,4).…”