Prevalence of Helicobacter pylori resistance to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone in Brazil.
BACKGROUND
Helicobacter pylori infection is associated with a wide range of digestive diseases and is very prevalent in developing countries, although few data exist on the susceptibility of H. pylori to antimicrobials commonly used in eradication schedules in these countries. The aim of this study was to evaluate the resistance of H. pylori to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone in dyspeptic Brazilian patients. Material and Methods. Ninety consecutive H. pylori-positive patients were enrolled. Resistance was evaluated by an agar dilution test.


RESULTS
Resistance to metronidazole was detected in 38 patients (42%); to amoxicillin in 26 individuals (29%); to clarithromycin in 6 patients (7%); to tetracycline in 6 patients (7%); and to furazolidone in 4 individuals (4%). Thirteen strains were resistant to two agents, and eight strains were resistant to three antimicrobials.


CONCLUSIONS
These results confirm the need for culture and susceptibility testing to define H. pylori resistance patterns in particular geographical areas before the general use of an eradication schedule. They also suggest the possibility of resistance to such antimicrobials as amoxicillin or tetracycline in geographical areas with a high prevalence of H. pylori infection and still not fully evaluated for antimicrobial susceptibility.
Mendonça
S
S
Clinical Pharmacology and Gastroenterology Unit, São Francisco University Medical School, Bragança Paulista, SP, Brazil.
Ecclissato
C
C
Sartori
M S
MS
Godoy
A P
AP
Guerzoni
R A
RA
Degger
M
M
Pedrazzoli
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple / Q000502:physiology*; D004415:Dyspepsia / Q000382:microbiology*; D005260:Female; D005664:Furazolidone / Q000494:pharmacology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology; D008875:Middle Aged; D010406:Penicillins / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D010406:Penicillins; D008795:Metronidazole; D005664:Furazolidone; D000658:Amoxicillin