title: [Helicobacter pylori resistance against metronidazole in Switzerland: implications for eradication therapy?].
abstract: Gastroduodenal ulcers are strongly associated with Helicobacter pylori (HP) infection. Successful eradication drastically diminishes ulcer recurrence. Most of the eradication schemes include metronidazole (Flagyl). The present study was designed to establish the metronidazole resistance rate in Switzerland. Antral biopsies were taken in 153 patients with suspected ulcers (115 men, 38 women, mean age 46 +/- 16 [SD] years) during upper endoscopy for bacteriological testing. Metronidazole resistance (> 8 micrograms/ml) was found in 47/153 (31%) of the isolates. Resistance was found in no case to amoxicillin (Clamoxyl) (0/104 = 0%) and only in 3% (2/66) to clarithromycin (Klazid). Metronidazole resistance of HP in a third of the isolates studied is comparable to numbers found in other European countries. These findings raise the question whether eradication schemes including metronidazole without prior sensitivity testing are justified. Amoxicillin and clarithromycin appear to be valid alternatives.
authors.affiliation: Abteilung für Gastroenterologie, Kantonsspital Basel.
authors.forename: C C
authors.initials: CC
authors.lastname: Sieber
authors.forename: R
authors.initials: R
authors.lastname: Frei
authors.forename: C
authors.initials: C
authors.lastname: Beglinger
authors.forename: S
authors.initials: S
authors.lastname: Mossi
authors.forename: J
authors.initials: J
authors.lastname: Binek
authors.forename: H
authors.initials: H
authors.lastname: Schaufelberger
authors.forename: R
authors.initials: R
authors.lastname: Fried
authors.forename: G A
authors.initials: GA
authors.lastname: Stalder
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D013557:Switzerland
chemical_list: D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin
vernacular_title: Resistenz von Helicobacter pylori gegen Metronidazol in der Schweiz: Implikationen für die Eradikationstherapie?