Helicobacter pylori Clarithromycin Resistance and Treatment Failure Are Common in the USA
Background Helicobacter pylori antibiotic resistance leads to frequent treatment failure. However, the current US prevalence of H. pylori clarithromycin resistance and treatment failure is unknown. Aims To determine the prevalence of clarithromycin-resistant H. pylori and its impact on treatment fai...
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| Veröffentlicht in: | Digestive diseases and sciences 2016-08, Vol.61 (8), p.2373-2380 |
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| creator | Park, Jason Y. Dunbar, Kerry B. Mitui, Midori Arnold, Christina A. Lam-Himlin, Dora M. Valasek, Mark A. Thung, Irene Okwara, Chinemerem Coss, Elizabeth Cryer, Byron Doern, Christopher D. |
| description | Background
Helicobacter pylori
antibiotic resistance leads to frequent treatment failure. However, the current US prevalence of
H. pylori
clarithromycin resistance and treatment failure is unknown.
Aims
To determine the prevalence of clarithromycin-resistant
H. pylori
and its impact on treatment failure in the USA.
Methods
A multicenter, retrospective, cohort study for clarithromycin-resistant
H. pylori
was conducted over four academic medical centers in different geographic regions of the USA. Gastric biopsy material, residual from standard clinical pathologic examination, was examined for clarithromycin resistance by DNA sequencing of
H. pylori
23S rRNA.
Results
One hundred and twenty-four cases of
H. pylori
gastritis were examined from medical centers in four different geographic regions of the USA. The overall prevalence of clarithromycin resistance was 32.3 % (range 23.1–45.8 %). There was no significant difference in the prevalence of clarithromycin resistance by study site, gender, age, or race/ethnicity. In a subset of 67 patients that had clinical follow-up data, the overall prevalence of clarithromycin resistance was 31.3 %. There was a 2.9-fold increase (
p
= 0.002) in treatment failure for cases with clarithromycin resistance (57.1 %) compared to wildtype
H. pylori
(19.6 %).
Conclusions
H. pylori
clarithromycin resistance in the USA exceeds the estimated 20 % prevalence compatible with successful empiric antibiotic therapy. This resistance resulted in a significant rate of treatment failure in all sites surveyed. Empiric therapy in the USA should be used with caution until there is better regional or local determination of
H. pylori
antibiotic resistance. |
| doi_str_mv | 10.1007/s10620-016-4091-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1827928732</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712938882</galeid><sourcerecordid>A712938882</sourcerecordid><originalsourceid>FETCH-LOGICAL-c538t-bd76ff163046d4fefeee2054bc4bffe26a9b28bf5438f39c5b9c63d92040c33d3</originalsourceid><addsrcrecordid>eNqNkU1rFTEUhoMo9rb6A9zIgBs3U_M1mWR5uVgrFARtF65CJnPSpswk1ySzuP_eDLf1CwUJIYec5z05Jy9Crwg-Jxj37zLBguIWE9FyrEgrn6AN6XrW0k7Ip2hTEzUmRJyg05zvMcaqJ-I5OqFCUaa43KCvlzB5GwdjC6Rmf5hi8s1uMsmXuxTng_Wh-QzZ52KChcaEsblOYMoMoTQXxk9LgmZb9y7OcwxNxcsdNDdfti_QM2emDC8fzjN0c_H-enfZXn368HG3vWptx2Rph7EXztVGMRcjd-AAgOKOD5YPzgEVRg1UDq7jTDqmbDcoK9ioKObYMjayM_T2WHef4rcFctGzzxamyQSIS9ZE0l5R2TP6HyjmslO9FBV98wd6H5cU6iCVIoRy3mH5k7o1E2gfXCzJ2LWo3vaEKialXJ89_wtV1whz_fsAztf73wTkKLAp5pzA6X3ys0kHTbBenddH53U1WK_O67WV1w8NL8MM4w_Fo9UVoEcg11S4hfTLRP-s-h2IxLZP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1811244508</pqid></control><display><type>article</type><title>Helicobacter pylori Clarithromycin Resistance and Treatment Failure Are Common in the USA</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Park, Jason Y. ; Dunbar, Kerry B. ; Mitui, Midori ; Arnold, Christina A. ; Lam-Himlin, Dora M. ; Valasek, Mark A. ; Thung, Irene ; Okwara, Chinemerem ; Coss, Elizabeth ; Cryer, Byron ; Doern, Christopher D.</creator><creatorcontrib>Park, Jason Y. ; Dunbar, Kerry B. ; Mitui, Midori ; Arnold, Christina A. ; Lam-Himlin, Dora M. ; Valasek, Mark A. ; Thung, Irene ; Okwara, Chinemerem ; Coss, Elizabeth ; Cryer, Byron ; Doern, Christopher D.</creatorcontrib><description>Background
Helicobacter pylori
antibiotic resistance leads to frequent treatment failure. However, the current US prevalence of
H. pylori
clarithromycin resistance and treatment failure is unknown.
Aims
To determine the prevalence of clarithromycin-resistant
H. pylori
and its impact on treatment failure in the USA.
Methods
A multicenter, retrospective, cohort study for clarithromycin-resistant
H. pylori
was conducted over four academic medical centers in different geographic regions of the USA. Gastric biopsy material, residual from standard clinical pathologic examination, was examined for clarithromycin resistance by DNA sequencing of
H. pylori
23S rRNA.
Results
One hundred and twenty-four cases of
H. pylori
gastritis were examined from medical centers in four different geographic regions of the USA. The overall prevalence of clarithromycin resistance was 32.3 % (range 23.1–45.8 %). There was no significant difference in the prevalence of clarithromycin resistance by study site, gender, age, or race/ethnicity. In a subset of 67 patients that had clinical follow-up data, the overall prevalence of clarithromycin resistance was 31.3 %. There was a 2.9-fold increase (
p
= 0.002) in treatment failure for cases with clarithromycin resistance (57.1 %) compared to wildtype
H. pylori
(19.6 %).
Conclusions
H. pylori
clarithromycin resistance in the USA exceeds the estimated 20 % prevalence compatible with successful empiric antibiotic therapy. This resistance resulted in a significant rate of treatment failure in all sites surveyed. Empiric therapy in the USA should be used with caution until there is better regional or local determination of
H. pylori
antibiotic resistance.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-016-4091-8</identifier><identifier>PMID: 26923948</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amoxicillin - therapeutic use ; Antacids - therapeutic use ; Anti-Bacterial Agents - therapeutic use ; Biochemistry ; Bismuth - therapeutic use ; Clarithromycin ; Clarithromycin - therapeutic use ; Cohort Studies ; DNA sequencing ; Drug resistance in microorganisms ; Drug Resistance, Bacterial - genetics ; Drug Therapy, Combination ; Female ; Gastric Mucosa ; Gastritis - drug therapy ; Gastritis - epidemiology ; Gastritis - microbiology ; Gastroenterology ; Helicobacter Infections - drug therapy ; Helicobacter Infections - epidemiology ; Helicobacter Infections - microbiology ; Helicobacter pylori ; Helicobacter pylori - genetics ; Helicobacter pylori - physiology ; Hepatology ; Humans ; Male ; Medical centers ; Medical colleges ; Medicine ; Medicine & Public Health ; Metronidazole - therapeutic use ; Middle Aged ; Nucleotide sequencing ; Oncology ; Original Article ; Prevalence ; Proton Pump Inhibitors - therapeutic use ; Retrospective Studies ; RNA ; RNA, Ribosomal, 23S - genetics ; Transplant Surgery ; Treatment Failure ; United States - epidemiology ; Young Adult</subject><ispartof>Digestive diseases and sciences, 2016-08, Vol.61 (8), p.2373-2380</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>COPYRIGHT 2016 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c538t-bd76ff163046d4fefeee2054bc4bffe26a9b28bf5438f39c5b9c63d92040c33d3</citedby><cites>FETCH-LOGICAL-c538t-bd76ff163046d4fefeee2054bc4bffe26a9b28bf5438f39c5b9c63d92040c33d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-016-4091-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-016-4091-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26923948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Jason Y.</creatorcontrib><creatorcontrib>Dunbar, Kerry B.</creatorcontrib><creatorcontrib>Mitui, Midori</creatorcontrib><creatorcontrib>Arnold, Christina A.</creatorcontrib><creatorcontrib>Lam-Himlin, Dora M.</creatorcontrib><creatorcontrib>Valasek, Mark A.</creatorcontrib><creatorcontrib>Thung, Irene</creatorcontrib><creatorcontrib>Okwara, Chinemerem</creatorcontrib><creatorcontrib>Coss, Elizabeth</creatorcontrib><creatorcontrib>Cryer, Byron</creatorcontrib><creatorcontrib>Doern, Christopher D.</creatorcontrib><title>Helicobacter pylori Clarithromycin Resistance and Treatment Failure Are Common in the USA</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
Helicobacter pylori
antibiotic resistance leads to frequent treatment failure. However, the current US prevalence of
H. pylori
clarithromycin resistance and treatment failure is unknown.
Aims
To determine the prevalence of clarithromycin-resistant
H. pylori
and its impact on treatment failure in the USA.
Methods
A multicenter, retrospective, cohort study for clarithromycin-resistant
H. pylori
was conducted over four academic medical centers in different geographic regions of the USA. Gastric biopsy material, residual from standard clinical pathologic examination, was examined for clarithromycin resistance by DNA sequencing of
H. pylori
23S rRNA.
Results
One hundred and twenty-four cases of
H. pylori
gastritis were examined from medical centers in four different geographic regions of the USA. The overall prevalence of clarithromycin resistance was 32.3 % (range 23.1–45.8 %). There was no significant difference in the prevalence of clarithromycin resistance by study site, gender, age, or race/ethnicity. In a subset of 67 patients that had clinical follow-up data, the overall prevalence of clarithromycin resistance was 31.3 %. There was a 2.9-fold increase (
p
= 0.002) in treatment failure for cases with clarithromycin resistance (57.1 %) compared to wildtype
H. pylori
(19.6 %).
Conclusions
H. pylori
clarithromycin resistance in the USA exceeds the estimated 20 % prevalence compatible with successful empiric antibiotic therapy. This resistance resulted in a significant rate of treatment failure in all sites surveyed. Empiric therapy in the USA should be used with caution until there is better regional or local determination of
H. pylori
antibiotic resistance.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amoxicillin - therapeutic use</subject><subject>Antacids - therapeutic use</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biochemistry</subject><subject>Bismuth - therapeutic use</subject><subject>Clarithromycin</subject><subject>Clarithromycin - therapeutic use</subject><subject>Cohort Studies</subject><subject>DNA sequencing</subject><subject>Drug resistance in microorganisms</subject><subject>Drug Resistance, Bacterial - genetics</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Gastric Mucosa</subject><subject>Gastritis - drug therapy</subject><subject>Gastritis - epidemiology</subject><subject>Gastritis - microbiology</subject><subject>Gastroenterology</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter Infections - microbiology</subject><subject>Helicobacter pylori</subject><subject>Helicobacter pylori - genetics</subject><subject>Helicobacter pylori - physiology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical centers</subject><subject>Medical colleges</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metronidazole - therapeutic use</subject><subject>Middle Aged</subject><subject>Nucleotide sequencing</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Prevalence</subject><subject>Proton Pump Inhibitors - therapeutic use</subject><subject>Retrospective Studies</subject><subject>RNA</subject><subject>RNA, Ribosomal, 23S - genetics</subject><subject>Transplant Surgery</subject><subject>Treatment Failure</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU1rFTEUhoMo9rb6A9zIgBs3U_M1mWR5uVgrFARtF65CJnPSpswk1ySzuP_eDLf1CwUJIYec5z05Jy9Crwg-Jxj37zLBguIWE9FyrEgrn6AN6XrW0k7Ip2hTEzUmRJyg05zvMcaqJ-I5OqFCUaa43KCvlzB5GwdjC6Rmf5hi8s1uMsmXuxTng_Wh-QzZ52KChcaEsblOYMoMoTQXxk9LgmZb9y7OcwxNxcsdNDdfti_QM2emDC8fzjN0c_H-enfZXn368HG3vWptx2Rph7EXztVGMRcjd-AAgOKOD5YPzgEVRg1UDq7jTDqmbDcoK9ioKObYMjayM_T2WHef4rcFctGzzxamyQSIS9ZE0l5R2TP6HyjmslO9FBV98wd6H5cU6iCVIoRy3mH5k7o1E2gfXCzJ2LWo3vaEKialXJ89_wtV1whz_fsAztf73wTkKLAp5pzA6X3ys0kHTbBenddH53U1WK_O67WV1w8NL8MM4w_Fo9UVoEcg11S4hfTLRP-s-h2IxLZP</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Park, Jason Y.</creator><creator>Dunbar, Kerry B.</creator><creator>Mitui, Midori</creator><creator>Arnold, Christina A.</creator><creator>Lam-Himlin, Dora M.</creator><creator>Valasek, Mark A.</creator><creator>Thung, Irene</creator><creator>Okwara, Chinemerem</creator><creator>Coss, Elizabeth</creator><creator>Cryer, Byron</creator><creator>Doern, Christopher D.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>20160801</creationdate><title>Helicobacter pylori Clarithromycin Resistance and Treatment Failure Are Common in the USA</title><author>Park, Jason Y. ; Dunbar, Kerry B. ; Mitui, Midori ; Arnold, Christina A. ; Lam-Himlin, Dora M. ; Valasek, Mark A. ; Thung, Irene ; Okwara, Chinemerem ; Coss, Elizabeth ; Cryer, Byron ; Doern, Christopher D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c538t-bd76ff163046d4fefeee2054bc4bffe26a9b28bf5438f39c5b9c63d92040c33d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amoxicillin - therapeutic use</topic><topic>Antacids - therapeutic use</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biochemistry</topic><topic>Bismuth - therapeutic use</topic><topic>Clarithromycin</topic><topic>Clarithromycin - therapeutic use</topic><topic>Cohort Studies</topic><topic>DNA sequencing</topic><topic>Drug resistance in microorganisms</topic><topic>Drug Resistance, Bacterial - genetics</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Gastric Mucosa</topic><topic>Gastritis - drug therapy</topic><topic>Gastritis - epidemiology</topic><topic>Gastritis - microbiology</topic><topic>Gastroenterology</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter Infections - microbiology</topic><topic>Helicobacter pylori</topic><topic>Helicobacter pylori - genetics</topic><topic>Helicobacter pylori - physiology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical centers</topic><topic>Medical colleges</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metronidazole - therapeutic use</topic><topic>Middle Aged</topic><topic>Nucleotide sequencing</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Prevalence</topic><topic>Proton Pump Inhibitors - therapeutic use</topic><topic>Retrospective Studies</topic><topic>RNA</topic><topic>RNA, Ribosomal, 23S - genetics</topic><topic>Transplant Surgery</topic><topic>Treatment Failure</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Jason Y.</creatorcontrib><creatorcontrib>Dunbar, Kerry B.</creatorcontrib><creatorcontrib>Mitui, Midori</creatorcontrib><creatorcontrib>Arnold, Christina A.</creatorcontrib><creatorcontrib>Lam-Himlin, Dora M.</creatorcontrib><creatorcontrib>Valasek, Mark A.</creatorcontrib><creatorcontrib>Thung, Irene</creatorcontrib><creatorcontrib>Okwara, Chinemerem</creatorcontrib><creatorcontrib>Coss, Elizabeth</creatorcontrib><creatorcontrib>Cryer, Byron</creatorcontrib><creatorcontrib>Doern, Christopher D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Jason Y.</au><au>Dunbar, Kerry B.</au><au>Mitui, Midori</au><au>Arnold, Christina A.</au><au>Lam-Himlin, Dora M.</au><au>Valasek, Mark A.</au><au>Thung, Irene</au><au>Okwara, Chinemerem</au><au>Coss, Elizabeth</au><au>Cryer, Byron</au><au>Doern, Christopher D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Helicobacter pylori Clarithromycin Resistance and Treatment Failure Are Common in the USA</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>61</volume><issue>8</issue><spage>2373</spage><epage>2380</epage><pages>2373-2380</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>Background
Helicobacter pylori
antibiotic resistance leads to frequent treatment failure. However, the current US prevalence of
H. pylori
clarithromycin resistance and treatment failure is unknown.
Aims
To determine the prevalence of clarithromycin-resistant
H. pylori
and its impact on treatment failure in the USA.
Methods
A multicenter, retrospective, cohort study for clarithromycin-resistant
H. pylori
was conducted over four academic medical centers in different geographic regions of the USA. Gastric biopsy material, residual from standard clinical pathologic examination, was examined for clarithromycin resistance by DNA sequencing of
H. pylori
23S rRNA.
Results
One hundred and twenty-four cases of
H. pylori
gastritis were examined from medical centers in four different geographic regions of the USA. The overall prevalence of clarithromycin resistance was 32.3 % (range 23.1–45.8 %). There was no significant difference in the prevalence of clarithromycin resistance by study site, gender, age, or race/ethnicity. In a subset of 67 patients that had clinical follow-up data, the overall prevalence of clarithromycin resistance was 31.3 %. There was a 2.9-fold increase (
p
= 0.002) in treatment failure for cases with clarithromycin resistance (57.1 %) compared to wildtype
H. pylori
(19.6 %).
Conclusions
H. pylori
clarithromycin resistance in the USA exceeds the estimated 20 % prevalence compatible with successful empiric antibiotic therapy. This resistance resulted in a significant rate of treatment failure in all sites surveyed. Empiric therapy in the USA should be used with caution until there is better regional or local determination of
H. pylori
antibiotic resistance.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26923948</pmid><doi>10.1007/s10620-016-4091-8</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0163-2116 |
| ispartof | Digestive diseases and sciences, 2016-08, Vol.61 (8), p.2373-2380 |
| issn | 0163-2116 1573-2568 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1827928732 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Amoxicillin - therapeutic use Antacids - therapeutic use Anti-Bacterial Agents - therapeutic use Biochemistry Bismuth - therapeutic use Clarithromycin Clarithromycin - therapeutic use Cohort Studies DNA sequencing Drug resistance in microorganisms Drug Resistance, Bacterial - genetics Drug Therapy, Combination Female Gastric Mucosa Gastritis - drug therapy Gastritis - epidemiology Gastritis - microbiology Gastroenterology Helicobacter Infections - drug therapy Helicobacter Infections - epidemiology Helicobacter Infections - microbiology Helicobacter pylori Helicobacter pylori - genetics Helicobacter pylori - physiology Hepatology Humans Male Medical centers Medical colleges Medicine Medicine & Public Health Metronidazole - therapeutic use Middle Aged Nucleotide sequencing Oncology Original Article Prevalence Proton Pump Inhibitors - therapeutic use Retrospective Studies RNA RNA, Ribosomal, 23S - genetics Transplant Surgery Treatment Failure United States - epidemiology Young Adult |
| title | Helicobacter pylori Clarithromycin Resistance and Treatment Failure Are Common in the USA |
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