ALARCON T, MARTINEZ MJ, MADRUGA D, DOMINGO D, PRIETA N, LOPEZ-BREA M; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 696 (abstract no. 2223).

Hosp. de la Princesa, Madrid, SPAIN

BACKGROUND: The aim of this study was to determine the effect of the amoxicillin (A), clarithromycin (C) or metronidazole (M) MICs of the H. pylori clinical isolates on the eradication rates when using these antibiotics as anti-H. pylori therapies in a pediatric population.METHODS: 92 pediatric patients submitted to endoscopy were studied. 14 patients were treated with omeprazole (O) plus A (OA), 6 with OC, 16 with OCA and 56 with bismuth subcitrate, A and M (BAM). H. pylori was cultured from antrum biopsy sample and susceptibility to A, M and C was carried out by an agar dilution. Two-fold dilutions of antibiotic were included in the agar, a high inoculum applied using a Steer replicator and plates incubated for 3 to 5 days. MIC was recorded as the lowest concentration that inhibited visible growth. Eradication was considered when UBT was negative 1 or 6 months after treatment or when all endoscopic methods were negative (before UBT was available).RESULTS: The overall eradication rate was 21.4% with OA, 50% with OC, 66.6% with OCA and 78.5% with BAM. When these data were analyzed according to MIC level of each antibiotic the results were as follows: (a) OA eradication rates: 37.5% (3/8 patients) when MIC-A <0.016mg/l and 0% (0/6) when MIC-A >0.032mg/L; (b) OC eradication rates: 100% (4/4) when MIC-C <1mg/L and 0% (0/2) when MIC-C >2mg/L; (c) OCA eradication rates: 83.3% (10/12) when MIC-C <1mg/L and 0% (0/4) when MIC-C >2mg/L. 83.3% (5/6) when MIC-A <0.016mg/l and 50% (5/10) when MIC-A >0.032mg/L. Among the C susceptible strains eradication was obtained in 100% (5/5 patients) with MIC-A <0.016 and in 71% (5/7 patients) with MIC-A >0.032mg/ L; (d) BAM eradication rates: 88.1% (37/42) when MIC-M < ;2mg/L, 50% (3/6) when MIC-M= 4 to 8 mg/L and 50% (4/8) when MIC-M >16mg/L. 88.5% (31/35) when MIC-A <0.016mg/l and 61.9% (13/21) when MIC-A >0.032mg/L.CONCLUSIONS: A decrease in the eradication rate was observed when the patient is infected with H. pylori strains with higher MICs to amoxicillin, clarithromycin or metronidazole in the pediatric populations studied.

Publication Types:

• Meeting Abstracts

Keywords:

• Amoxicillin
• Anti-Bacterial Agents
• Child
• Clarithromycin
• Helicobacter pylori
• Humans
• Metronidazole
• Microbial Sensitivity Tests
• Omeprazole
• Population
• Population Groups
• Treatment Failure

Other ID:

• GWAIDS0008880

UI: 102246377

From Meeting Abstracts