PMID- 22469191
OWN - NLM
STAT- MEDLINE
DCOM- 20120628
LR  - 20131121
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 35
IP  - 10
DP  - 2012 May
TI  - Is Helicobacter pylori antibiotic resistance surveillance needed and how can it 
      be delivered?
PG  - 1221-30
LID - 10.1111/j.1365-2036.2012.05083.x [doi]
AB  - BACKGROUND: Most patients are prescribed Helicobacter pylori treatment without 
      culture and antibiotic susceptibility testing, as current guidance recommends 
      that patients with recurrent dyspepsia should be tested for H. pylori using a 
      non-invasive breath or faecal antigen test. AIMS: To determine the prevalence of 
      H. pylori antibiotic resistance in patients attending endoscopy in England and 
      Wales, and the feasibility of an antibiotic resistance surveillance programme 
      testing. METHODS: We tested the antibiotic susceptibility of H. pylori isolates 
      from biopsy specimens from 2063 of 7791 (26%) patients attending for endoscopy in 
      Gloucester and Bangor, and 339 biopsy specimens sent to the Helicobacter 
      Reference Unit (HRU) in London. Culture and susceptibility testing was undertaken 
      in line with National and European methods. RESULTS: Helicobacter pylori were 
      cultured in 6.4% of 2063 patients attending Gloucester and Bangor hospitals. 
      Resistance to amoxicillin, tetracycline and rifampicin/rifabutin was below 3% at 
      all centres. Clarithromycin, metronidazole and quinolone resistance was 
      significantly higher in HRU (68%, 88%, 17%) and Bangor isolates (18%, 43%, 13%) 
      than Gloucester (3%, 22%, 1%). Each previous course of these antibiotics is 
      associated with an increase in the risk of antibiotic resistance to that agent 
      [clarithromycin: RR = 1.5 (P = 0.12); metronidazole RR = 1.6 (P = 0.002); 
      quinolone RR = 1.8 (P = 0.01)]. CONCLUSIONS: Helicobacter pylori infection is now 
      uncommon in dyspeptic patients at endoscopy. A surveillance system is feasible 
      and necessary to inform dyspepsia management guidance. Clinicians should take a 
      thorough antibiotic history before prescribing metronidazole, clarithromycin or 
      levofloxacin for H. pylori.
CI  - (c) 2012 Blackwell Publishing Ltd.
FAU - McNulty, C A M
AU  - McNulty CA
AD  - Primary Care Unit, Health Protection Agency, Gloucestershire Royal Hospital, 
      Gloucester, UK. cliodna.mcnulty@hpa.org.uk
FAU - Lasseter, G
AU  - Lasseter G
FAU - Shaw, I
AU  - Shaw I
FAU - Nichols, T
AU  - Nichols T
FAU - D'Arcy, S
AU  - D'Arcy S
FAU - Lawson, A J
AU  - Lawson AJ
FAU - Glocker, E
AU  - Glocker E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120402
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Anti-Bacterial Agents)
RN  - 140QMO216E (Metronidazole)
RN  - 6GNT3Y5LMF (Levofloxacin)
RN  - A4P49JAZ9H (Ofloxacin)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
CIN - Aliment Pharmacol Ther. 2012 Jul;36(2):197-8; discussion 198-9. PMID: 22703454
CIN - Aliment Pharmacol Ther. 2012 Dec;36(11-12):1102; author reply 1103. PMID: 
      23130773
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Clarithromycin/therapeutic use
MH  - Drug Resistance, Microbial/*drug effects
MH  - Dyspepsia/*drug therapy
MH  - Endoscopy
MH  - England
MH  - Female
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Levofloxacin
MH  - Male
MH  - Metronidazole/therapeutic use
MH  - Microbial Sensitivity Tests/methods
MH  - Ofloxacin/therapeutic use
MH  - Risk Factors
MH  - Wales
EDAT- 2012/04/04 06:00
MHDA- 2012/06/29 06:00
CRDT- 2012/04/04 06:00
PHST- 2011/12/15 00:00 [received]
PHST- 2011/12/29 00:00 [revised]
PHST- 2012/03/08 00:00 [revised]
PHST- 2012/03/10 00:00 [accepted]
PHST- 2012/04/04 06:00 [entrez]
PHST- 2012/04/04 06:00 [pubmed]
PHST- 2012/06/29 06:00 [medline]
AID - 10.1111/j.1365-2036.2012.05083.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2012 May;35(10):1221-30. doi: 
      10.1111/j.1365-2036.2012.05083.x. Epub 2012 Apr 2.