PMID- 11000734
OWN - NLM
STAT- MEDLINE
DCOM- 20001005
LR  - 20161013
IS  - 0929-6646 (Print)
IS  - 0929-6646 (Linking)
VI  - 99
IP  - 9
DP  - 2000 Sep
TI  - Impact of Helicobacter pylori antimicrobial resistance on the outcome of 1-week 
      lansoprazole-based triple therapy.
PG  - 704-9
AB  - PURPOSE: To determine the effect of Helicobacter pylori antimicrobial resistance 
      on the efficacy of different proton pump inhibitor (PPI)-based triple therapies. 
      METHODS: One-hundred and twelve dyspeptic patients with H. pylori infection, as 
      demonstrated by positive histology and culture, were randomized to receive one of 
      the three PPI-based triple therapies. The regimens included lansoprazole (L) plus 
      any two of the following three antibiotics: amoxicillin (A), metronidazole (M), 
      and clarithromycin (C); patients were allocated to ALC, MLC, and ALM subgroups. 
      Six weeks after the start of triple therapy, the 13C-urea breath test (UBT) was 
      performed to evaluate the success of H. pylori eradication. Patients with 
      positive UBT results underwent endoscopy for H. pylori culture. The pre- and 
      post-treatment H. pylori isolates were analyzed for initial and acquired 
      resistance using the E-test. RESULTS: One hundred patients completed the study. 
      The H. pylori eradication rates were 70% (21/30) in the ALM subgroups, 79% 
      (26/33) in the MLC subgroup, and 89% (33/37) in the ALC subgroup. The frequencies 
      of pretreatment H. pylori antimicrobial resistance were 0% for amoxicillin 
      resistance (AR), 32% for metronidazole resistance (MR), and 6% for clarithromycin 
      resistance (CR). For H. pylori isolates with initial MR, the eradication rates in 
      the ALM (40%) and MLC (67%) subgroups were apparently lower than that in the ALC 
      (92%) subgroup. In the ALM and MLC subgroups (i.e., patients who received 
      metronidazole), the eradication failure rate was significantly higher for 
      patients with MR isolates than for patients with metronidazole-susceptible 
      isolates (47% vs 16%, p < 0.05). In the ALC and MLC subgroups (i.e., patients who 
      received clarithromycin), the eradication failure rate was significantly higher 
      for patients with CR isolates than for those with clarithromycin-susceptible 
      isolates (100% vs 11%, p < 0.05). CONCLUSIONS: The results indicate that H. 
      pylori antimicrobial resistance is relevant to the success of eradication. The 
      high MR but low CR and AR prevalence among H. pylori isolates in this study 
      suggests that PPI-based triple therapy including amoxicillin and clarithromycin 
      may achieve the most favorable eradication rate.
FAU - Huang, A H
AU  - Huang AH
AD  - Department of Pathology, National Cheng Kung University, Tainan, Taiwan.
FAU - Sheu, B S
AU  - Sheu BS
FAU - Yang, H B
AU  - Yang HB
FAU - Huang, C C
AU  - Huang CC
FAU - Wu, J J
AU  - Wu JJ
FAU - Lin, X Z
AU  - Lin XZ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Singapore
TA  - J Formos Med Assoc
JT  - Journal of the Formosan Medical Association = Taiwan yi zhi
JID - 9214933
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - 140QMO216E (Metronidazole)
RN  - 804826J2HU (Amoxicillin)
RN  - H1250JIK0A (Clarithromycin)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Adult
MH  - Amoxicillin/administration & dosage
MH  - Clarithromycin/administration & dosage
MH  - Drug Resistance, Microbial
MH  - Drug Therapy, Combination
MH  - Female
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Lansoprazole
MH  - Male
MH  - Metronidazole/administration & dosage
MH  - Omeprazole/administration & dosage/*analogs & derivatives
MH  - Prospective Studies
MH  - Treatment Outcome
EDAT- 2000/09/23 11:00
MHDA- 2000/10/07 11:01
CRDT- 2000/09/23 11:00
PHST- 2000/09/23 11:00 [pubmed]
PHST- 2000/10/07 11:01 [medline]
PHST- 2000/09/23 11:00 [entrez]
PST - ppublish
SO  - J Formos Med Assoc. 2000 Sep;99(9):704-9.