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Clarithromycin resistance and eradication of Helicobacter pylori in children

N Kalach1, P H Benhamou, F Campeotto

  • 1Division of Gastroenterology, Department of Pediatrics, Hôpital Saint Vincent de Paul, 75674 Paris Cedex 14, France.

Antimicrobial Agents and Chemotherapy
|June 16, 2001
PubMed

Insights

Clarithromycin triple therapy eradicated Helicobacter pylori in children with susceptible strains. Resistance to clarithromycin in H. pylori prevents eradication, making susceptibility testing essential before treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Helicobacter pylori infection is common in children.
  • Triple therapy regimens are standard for H. pylori eradication.
  • Clarithromycin resistance is a growing concern globally.

Purpose of the Study:

  • To evaluate the efficacy of clarithromycin-based triple therapy in pediatric H. pylori infection.
  • To determine the impact of clarithromycin resistance on treatment outcomes.
  • To emphasize the importance of antimicrobial susceptibility testing.

Main Methods:

  • Prospective analysis of 61 children treated with clarithromycin triple therapy.
  • Assessment of bacterial eradication post-treatment.
  • Correlation of eradication rates with clarithromycin susceptibility of H. pylori strains.

Main Results:

  • Successful eradication in all children with clarithromycin-susceptible H. pylori strains.
  • No eradication achieved in children with clarithromycin-resistant H. pylori strains (P = 0.0001).
  • Significant difference in outcomes based on bacterial susceptibility.

Conclusions:

  • H. pylori antimicrobial susceptibility testing is crucial before initiating treatment in children.
  • Clarithromycin should not be used empirically in areas with high resistance rates.
  • Tailoring therapy based on susceptibility testing improves eradication rates.

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