Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy

Abstract

A 2-fold increase in primary clarithromycin resistance in H. pylori strains occurred during the last 15 years in Italy. A2143G remains the most prevalent point mutation involved, thus suggesting that new therapeutic strategies are needed.

Detection of Helicobacter pylori DNA sequences in gastric biopsy samples to refine the diagnosis and therapy

“…Ultimately, HSpA displayed a less effective performance, since it was positive in 41 infected subjects (82 %) and the concordance with RT-PCR was poor (Cohen's k50.21; CI 0-0.498). Finally, RT-PCR found the A2143G mutation in 11 cases, with a prediction of treatment failure of 22 %, a value that is comparable to clarithromycin resistance reports in some areas of Italy (De Francesco et al, 2011), thus confirming the increasing trend of antibiotic resistances towards clarithromycin in Italy (Ierardi et al, 2013). In the control group, RT-PCR did not detect H. pylori genetic sequences in any sample.…”

Primary clarithromycin resistance toHelicobacter pylori: Is this the main reason for triple therapy failure?

“…However, in the same period a study by our group found a median value of 28.7% in two areas in Southern and Central Italy [9] . In 2007, in a retrospective study performed over a 15-year period in the same geographical area, we found a 10.2% prevalence of primary clarithromycin resistance in 147 patients in the 1990 period, whereas by 2004-2005 the resistance found in 178 patients had increased significantly, to 21.3% or 2-fold higher [10] . The phenomenon was found to be more evident in females.…”

Two-week Triple Therapy with either Standard or High-dose Esomeprazole for First-line H. pylori Eradication

“…The use of increased PPI doses is another suggestion to improve the cure rate of triple therapies [4]. In Southern and Central Italy, where this study was performed, the prevalence rate of primary clarithromycin resistance has been found to be higher than 20% [17,18]. Based on these observations, we peformed this study to test the efficacy of 14-day triple therapy with either standard or double PPI doses for first-line H. pylori eradication.…”