title: Implications of antibiotic resistance in the management of Helicobacter pylori infection: Canadian Helicobacter Study Group.
abstract: Eradication of Helicobacter pylori from the gastric and duodenal mucosa is an important clinical goal in the treatment of infected patients with peptic ulcer disease and other H pylori-associated conditions. Although several oral drug combination regimens are associated with eradication rates of approximately 85% in controlled trials, the success rate in patients infected with a resistant strain of H pylori is closer to 75%. Resistance to metronidazole and clarithromycin, which are common components of combination treatment regimens, is of greatest concern. Reported rates of H pylori resistance to various antibiotics vary considerably. In Canada, the data documenting H pylori susceptibility are limited but suggest that resistance to these antibiotics varies geographically and within specific treatment groups. Although susceptibility testing is not a prerequisite for initial treatment of individual patients infected with H pylori, formal efforts to identify and monitor both the causes and prevalence of antibiotic resistance across Canada are a much needed step in the ongoing management of this important infection. Recommended treatment regimens may be useful, even for treating apparently resistant H pylori strains. However, it is important to understand the mechanisms of the development of resistant strains to manage patients with treatment failure better.
authors: Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada. huntr@fhsadmin.csu.mcmaster.ca
authors: R H
authors: RH
authors: Hunt
authors: F M
authors: FM
authors: Smaill
authors: C A
authors: CA
authors: Fallone
authors: P M
authors: PM
authors: Sherman
authors: S J
authors: SJ
authors: Veldhuyzen van Zanten
authors: A B
authors: AB
authors: Thomson
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D017354:Point Mutation
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D017291:Clarithromycin