Role of Antimicrobial Susceptibility Testing before First-Line Treatment Containing Clarithromycin for Helicobacter pylori Eradication in the Clinical Setting

被引:9
作者
Kang, Seokin [1 ]
Kim, Yuri [1 ]
Ahn, Ji Yong [1 ]
Jung, Hwoon-Yong [1 ]
Kim, Nayoung [2 ]
Na, Hee Kyong [1 ]
Lee, Jeong Hoon [1 ]
Jung, Kee Wook [1 ]
Kim, Do Hoon [1 ]
Choi, Kee Don [1 ]
Song, Ho June [1 ]
Lee, Gin Hyug [1 ]
机构
[1] Univ Ulsan, Dept Gastroenterol, Asan Med Ctr, Coll Med, Seoul 05505, South Korea
[2] Univ Ulsan, Dept Clin Epidemiol & Biostat, Asan Med Ctr, Coll Med, Seoul 05505, South Korea
来源
ANTIBIOTICS-BASEL | 2021年 / 10卷 / 02期
关键词
Helicobacter pylori; Helicobacter infection; clarithromycin; microbial sensitivity tests; microbial drug resistance; THERAPY; INFECTION; HETERORESISTANCE; RESISTANCE; CULTURE; STRAINS; KOREA; RATES;
D O I
10.3390/antibiotics10020214
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Checking Helicobacter pylori susceptibility tests in the clinical setting before first-line treatment is considered difficult. We compared susceptibility-guided therapy (SGT) with empirical therapy (ET) as a first-line treatment containing clarithromycin and investigated the eradication rate using antimicrobial susceptibility testing (AST). Methods: 257 patients with H. pylori infection, with AST, performed before the eradication of clarithromycin-containing regimens were enrolled and divided into two groups: the SGT and ET groups. Results: Eradication rates in the SGT and ET groups were 85.4% and 58.4% (P < 0.01), respectively. In triple therapy (TT), eradication rates of the SGT and ET groups were 85.1% and 56.6% (P < 0.01), respectively. In sequential therapy (SET), eradication rates of the SGT and ET groups were 86.2% and 65.6% (P = 0.06), respectively. According to AST, TT had an eradication rate of 84.6% with strains susceptible to clarithromycin and amoxicillin and 11.1% with strains resistant to both. SET had an eradication rate of 89.5% with strains susceptible to clarithromycin, amoxicillin, and metronidazole, whereas it was 0% with strains resistant to clarithromycin and metronidazole. Conclusions: SGT as first-line treatment improved eradication rates of TT and SET by 28.5 (P < 0.01) and 20.6 (P = 0.06) percent points, respectively, compared with ET.
引用
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页码:1 / 11
页数:11
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