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Primary resistance to antibiotics and its clinical impact on the efficacy of Helicobacter pylori lansoprazole‐based triple therapies
Author(s) -
Poon S. K.,
Chang C. S.,
Su J.,
Lai C. H.,
Yang C. C.,
Chen G. H.,
Wang W. C.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01184.x
Subject(s) - lansoprazole , clarithromycin , metronidazole , helicobacter pylori , medicine , amoxicillin , breath test , gastroenterology , antibiotics , antibacterial agent , microbiology and biotechnology , biology
Aim: To evaluate Helicobacter pylori primary resistance and its clinical impact on the efficacy of two lansoprazole‐based eradication triple therapies. Methods: H. pylori ‐positive patients ( n =228) were randomized to receive one of the 1‐week regimens: lansoprazole 30 mg, clarithromycin 500 mg and amoxicillin 1 g (LAC), or lansoprazole 30 mg, clarithromycin 500 mg and metronidazole 500 mg (LMC), each given twice daily. H. pylori status was assessed by 13 C‐urea breath test and culture at diagnosis and by 13 C‐urea breath test 6 weeks after therapy. Antibiotic susceptibility was determined by E ‐test ( n =98). Results: The eradication rates with per protocol/ intention‐to‐treat analyses were: LAC ( n =95/114) 83%/69% and LMC ( n =96/114) 85%/72%. Primary resistance was 11% for clarithromycin, 41% for metronidazole and 0% for amoxicillin. Eradication in metronidazole‐susceptible/‐resistant strains was 85%/82% in LAC and 83%/63% in LMC. Significantly lower cure rates were observed in clarithromycin‐resistant patients treated with LAC (95% vs. 0%, P < 0.001) and LMC (86% vs. 0%, P < 0.001). Conclusions: One‐week LAC and LMC are similarly effective therapies. Clarithromycin resistance significantly affected H. pylori eradication in both regimens.