Causes of failure of eradication of Helicobacter pylori

doi:10.1136/bmj.325.7354.3

BMJ 2002;325:3-4 ( 6 July )

Editorials

Causes of failure of eradication of Helicobacter pylori

Antibiotic resistance is the major cause, and susceptibility testing may help

The first 150 words of the full text of this article appear below.

Eradication of Helicobacter pylori from the gastric and duodenal mucosa of infected patients is the most important goal inthe management of peptic ulcer disease and other conditions associatedwith H pylori.¹ The survival capabilities of H pylori in thestomach make it difficult to eradicate, and effective treatmentrequires multidrug regimens consisting of two antibiotics (usuallyselected from clarithromycin, metronidazole, amoxicillin, andtetracycline), combined with acid suppressants and bismuth compounds.²A significant proportion of patients do not respond to treatment,and adverse treatment outcome is associated with advanced age,smoking, high intragastric bacterial load before treatment, bacterialgenotype, and host genetic polymorphisms of the cytochrome-P450isoenzymes that are specifically involved in the metabolism ofproton pump inhibitors.³ Adherence to the drug regimen is particularlyimportant for successful eradication of infection and can be improvedby education of patients and programmes to improve compliance.⁴But as in many other . . . [Full text of this article]

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Chisholm, S. A., Owen, R. J. (2009). Frequency and molecular characteristics of ciprofloxacin- and rifampicin-resistant Helicobacter pylori from gastric infections in the UK. J Med Microbiol 58: 1322-1328 [Abstract] [Full text]
Cameron, E. A.B., Powell, K. U., Baldwin, L., Jones, P., Bell, G. D., Williams, S. G.J. (2004). Helicobacter pylori: antibiotic resistance and eradication rates in Suffolk, UK, 1991-2001. J Med Microbiol 53: 535-538 [Abstract] [Full text]

Rapid Responses:

Read all Rapid Responses

H pylori doesn't live only in the stomach!: Dr Trevor Watts
bmj.com, 5 Jul 2002 [Full text]
Re: H pylori doesn't live only in the stomach!: VH Chong
bmj.com, 9 Jul 2002 [Full text]
Re: Re: H pylori doesn't live only in the stomach!: Jamie S Wilson
bmj.com, 11 Jul 2002 [Full text]
Re: Re: H pylori doesn't live only in the stomach!: Dr Trevor Watts
bmj.com, 11 Jul 2002 [Full text]
Reduction of Helicobacter pylori and Lactobacilli.: Mahantayya V. Math
bmj.com, 14 Jul 2002 [Full text]
Excellent results can be achieved without sensitivity testing: Ian L. P. Beales
bmj.com, 17 Jul 2002 [Full text]