[Resistance to antibiotics used in Helicobacter pylori infection in children]

Area of Science:

• Microbiology
• Pediatric Infectious Diseases
• Pharmacology

Background:

• Antibiotic resistance in Helicobacter pylori (H. pylori) is a significant clinical challenge, impacting the efficacy of eradication therapies.
• Metronidazole and clarithromycin are key antibiotics used in H. pylori treatment, but resistance rates are increasing globally.
• Understanding drug resistance patterns, especially in pediatric populations, is crucial for optimizing treatment strategies.

Purpose of the Study:

• To evaluate primary and secondary drug resistance patterns of H. pylori in children undergoing eradication therapy.
• To determine the prevalence of resistance to metronidazole, clarithromycin, amoxicillin, and tetracyclines in pediatric H. pylori infections.
• To assess the impact of previous unsuccessful eradication attempts on antibiotic resistance.

Main Methods:

• A study involving 50 children with H. pylori infections was conducted.
• Drug resistance was assessed in children receiving initial eradication therapy and in 18 children with prior failed treatments.
• Antimicrobial susceptibility testing was performed to determine resistance to key antibiotics.

Main Results:

• High secondary resistance rates were observed for metronidazole (up to 72.0%) and macrolides (around 66.0%).
• Primary resistance to clarithromycin was 25.0%, and combined primary resistance to clarithromycin and metronidazole was 7.2%.
• No resistance to amoxicillin and tetracyclines was found in H. pylori isolates.

Conclusions:

• Significant primary and secondary antibiotic resistance to metronidazole and clarithromycin exists in pediatric H. pylori infections.
• The high resistance rates, especially secondary resistance, may explain treatment failures.
• Amoxicillin and tetracyclines remain effective options, suggesting their potential role in salvage therapies.