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Retrospective study on outcome of salvage Helicobacter pylori eradication therapies based on molecular genetic susceptibility testing
Author(s) -
Blümel Benjamin,
Goelz Hanna,
Kist Manfred,
Glocker ErikOliver
Publication year - 2018
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12494
Subject(s) - clarithromycin , helicobacter pylori , medicine , logistic regression , levofloxacin , retrospective cohort study , molecular diagnostics , genotype , antibiotics , genetic testing , gastroenterology , biology , bioinformatics , microbiology and biotechnology , gene , biochemistry
Background Antimicrobial susceptibility of Helicobacter (H.) pylori is usually determined by phenotypic methods. When H. pylori cannot be grown owing to contaminations or delay in transport of gastric tissue samples to the microbiological laboratory, molecular genetic testing is a reasonable alternative. The aim of this retrospective study was to assess the outcome of salvage eradication treatments based on molecular genetic susceptibility testing. Methods Data on 144 H. pylori PCR‐positive gastric tissue samples of patients primarily with prior unsuccessful eradication treatments were retrospectively analyzed. Eradication treatments were recommended based on genotypic clarithromycin and/or levofloxacin susceptibility as tested by real‐time PCR or reverse hybridization. Treatment success was assessed by attending physicians using urea breath test; stool‐antigen ELISA; and microbiology/histopathology. Results Overall success rate of molecular genetic testing‐guided salvage treatments was low (68%); none of the regimens chosen was significantly better than another. Multivariable logistic regression analysis did not reveal any factors that may predict treatment failure. Conclusions Eradication success was poor despite susceptibility testing. Gastroenterologists are advised to prescribe recommended salvage treatments, considering recommended dosages and prolonged treatment duration.