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Antimicrobial susceptibility testing effectively eradicated H. pylori
In a region with high rates of multiple drug-resistant Helicobacter pylori infection, pretreatment antimicrobial susceptibility-guided therapy was more effective at H. pylori eradication than conventional clarithromycin-based triple therapy, according to recent study data.
Researchers from Korea completed a clinical study of 112 H. pylori-positive patients with gastric epithelial neoplasm from November 2011 to October 2012. One-half of the cohort was randomly assigned to antibiotics determined by antimicrobial susceptibility-guided therapy, and the other half received conventional triple therapy (proton pump inhibitor, amoxicillin and clarithromycin), both for 1 week. Patients in both groups for whom eradication failed received antibiotics determined by antimicrobial susceptibility tests as a second-line treatment.
After initial treatment, the intention-to-treat eradication rates were 94.7% (95% CI, 88.8-100) in the antimicrobial susceptibility-guided group and 71.9% (95% CI, 60.2-83.5) in the clarithromycin-based triple therapy group (P=.002), according to the study data. Per protocol eradication rates were 96.4% (95% CI, 91.5-100) and 73.2% (95% CI, 61.5-84.8), respectively (P=.001). In H. pylori resistant to clarithromycin, eradication failure with initial treatment was 0% in the susceptibility-guided therapy group compared with 80% (95% CI, 59.7-100) in the triple therapy group (P<.001).
The researchers concluded that “pretreatment antimicrobial susceptibility-guided therapy is more effective than clarithromycin-based triple therapy for H. pylori eradication in a region with high rates of multiple drug resistance.”
Disclosure: The researchers report no relevant financial disclosures.