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Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
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Primary Antibiotic Resistance And Effectiveness Of Clarithromycin Vs Metronidazole Based Therapy For Helicobacter

Nadia Waheed1, Nighat Haider1, Muqaddar Shah1

  • 1Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.

Journal of Ayub Medical College, Abbottabad : JAMC
|February 26, 2024
PubMed

Insights

Antibiotic resistance is high in pediatric H. pylori infections. Clarithromycin and Metronidazole are often ineffective as first-line treatments for H. pylori eradication in children, requiring susceptibility testing.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Gastroenterology

Background:

  • National guidelines emphasize regional antibiotic susceptibility profiling for H. pylori eradication.
  • Understanding local resistance patterns is crucial for successful H. pylori treatment in children.
  • This study addresses primary resistance to Clarithromycin and Metronidazole in pediatric H. pylori infections.

Purpose of the Study:

  • To determine the primary resistance rates to Clarithromycin and Metronidazole.
  • To assess the efficacy of these antibiotics in pediatric H. pylori eradication regimens.
  • To inform treatment strategies based on local antimicrobial susceptibility.

Main Methods:

  • Children aged 2-14 with symptomatic H. pylori infection were enrolled.
  • H. pylori infection confirmed via stool antigen, rapid urease tests, and histology.
  • Antibiotic susceptibility testing performed on cultured biopsy specimens.

Main Results:

  • Of 54 children, 25.92% exhibited antimicrobial resistance.
  • 18/40 (45%) were sensitive to both Clarithromycin and Metronidazole.
  • 30% were resistant to Metronidazole but sensitive to Clarithromycin; 25% were sensitive to Metronidazole.

Conclusions:

  • Clarithromycin and Metronidazole show significant primary resistance in pediatric H. pylori infections.
  • These antibiotics should not be used as first-line treatment without known antimicrobial susceptibility.
  • Susceptibility testing is essential for effective H. pylori eradication in children.
Abstract

Keywords:
Clarithromycin; Metronidazole; Resistance rate; Helicobacter pylori

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