Primary Helicobacter pylori resistance in elderly patients over 20 years: A Bulgarian study

Boyanova, Lyudmila; Gergova, Galina; Markovska, Rumyana; Kandilarov, Nayden; Davidkov, Lyubomir; Spassova, Zoya; Mitov, Ivan

doi:10.1016/j.diagmicrobio.2017.05.001

“… 80–83 Studies have shown that the elderly population has no significantly increased resistance to antibiotics commonly used to eradicate H. pylori such as amoxicillin and furazolidone, but resistance to quinolone (levofloxacin) and clarithromycin has increased. 83 84 Eradication treatment should be considered for this population unless competing considerations exist.…”

Section: Resultsmentioning

confidence: 99%

Chinese Consensus Report on Family-BasedHelicobacter pyloriInfection Control and Management (2021 Edition)

Ding

¹

,

Du

²

,

Lü

³

et al. 2021

Gut

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Objective Helicobacter pyloriinfection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-basedH. pyloriinfection control and management to reduce the related disease burden. Methods Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. Results Experts discussed and modified the original 23 statements on family-basedH. pyloriinfection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1)H. pyloriinfection and transmission among family members, (2) prevention and management ofH. pyloriinfection in children and elderly people within households, and (3) strategies for prevention and management ofH. pyloriinfection for family members. In addition to the ‘test-and-treat’ and ‘screen-and-treat’ strategies, this consensus also introduced a novel third ‘family-basedH. pyloriinfection control and management’ strategy to prevent its intrafamilial transmission and development of related diseases. Conclusion H. pyloriis transmissible from person to person, and among family members. A family-basedH. pyloriprevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

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“…As yet, the studies on H. pylori resistance in elderly patients are very limited. 21 One Bulgarian study showed that the resistance rates were 22.6% (clarithromycin), 32.3% (levofloxacin), 1.6% (tetracycline) and 1.6% (amoxicillin) in elderly patients aged 66–93 years. 21 …”

Section: Discussionmentioning

confidence: 99%

Effect and Safety of Helicobacter pylori Eradication Treatment Based on Molecular Pathologic Antibiotic Resistance in Chinese Elderly People

Gao¹,

Yong-sheng²

2022

IDR

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Background The elderly people generally have poor tolerance to drugs and an increased risk of adverse effects. Our study was designed to determine the effect and safety of Helicobacter pylori ( H. pylori ) eradication treatment based on molecular pathologic antibiotic resistance in Chinese elderly people over the age of 60 years. Methods A total of 364 people were retrospectively analyzed, including 113 older people over 60 and 251 young and middle-aged people in the age of 20–59 years. Real-time PCR detection and conventional PCR and sequencing method were used for drug susceptibility testing. As the main outcome measure, the eradication rates (ERs) with their 95% confidence intervals (CIs) were analyzed by intention to treat (ITT) and per protocol (PP). For the safety of therapy, adverse events were analyzed. Results For the total people, the resistance rates to clarithromycin (CLR), amoxicillin (AMX), fluoroquinolone (FLQ) and tetracycline (TET) were 65.06%, 7.54%, 61.39% and 20.37%, respectively. After they were divided into two groups, the resistance rates were 62.39% (CLR), 9.09% (AMX), 69.64% (FLQ) and 22.45% (TET) in the 113 older people over 60, and 66.26%, 6.85%, 57.66% and 19.47% in the 251 young and middle-aged people in 20–59. By the ITT analysis, the ERs were 92.04% (95% CI, 86.97–97.10%, n=113) in the older people and 92.43% (95% CI, 89.14–95.73%, n=251) in the young and middle-aged people. By the PP analysis, the ERs were 96.30% (95% CI, 92.68–99.92%, n=108) and 94.69% (95% CI, 91.87–97.52%, n=245), respectively. No significant differences were shown both in the ITT analysis (P=0.896) and in the PP analysis (P=0.517). The three most common adverse events were black stool, dysgeusia and diarrhea, and no serious adverse event was reported. Conclusion H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in Chinese elderly people.

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“…The elderly population is more likely to be resistant to antibiotics because of excessive use in the past ( 91 , 92 ). A multicenter cohort study showed that people aged >40 years were particularly at risk of developing dual drug resistance to levofloxacin and metronidazole ( 93 ).…”

Section: Treatmentmentioning

confidence: 99%

Helicobacter pylori Infection in Geriatric Patients: Current Situation and Treatment Regimens

Huang

¹

,

Jia

²

,

Chu

³

et al. 2021

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Helicobacter pylori (H. pylori) has so far infected more than half the global population. It is the most important and controllable risk factor for gastric cancer. The elderly, who are at a higher incidence of the infection, are also commonly found to develop antibiotic resistance. The symptoms, diagnosis, clinical features (of gastric or extra-digestive diseases), and treatment of H. pylori infection in the elderly, are different from that in the non-elderly. Health conditions, including comorbidities and combined medication have limited the use of regular therapies in elderly patients. However, they can still benefit from eradication therapy, thus preventing gastric mucosal lesions and gastric cancer. In addition, new approaches, such as dual therapy and complementary therapy, have the potential to treat older patients with H. pylori infection.

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Primary Helicobacter pylori resistance in elderly patients over 20 years: A Bulgarian study

Cited by 11 publications

References 23 publications

Chinese Consensus Report on Family-BasedHelicobacter pyloriInfection Control and Management (2021 Edition)

Chinese Consensus Report on Family-BasedHelicobacter pyloriInfection Control and Management (2021 Edition)

Effect and Safety of Helicobacter pylori Eradication Treatment Based on Molecular Pathologic Antibiotic Resistance in Chinese Elderly People

Helicobacter pylori Infection in Geriatric Patients: Current Situation and Treatment Regimens

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