Influence of daily low-dose 14-membered-ring macrolide therapy on Helicobacter pylori infection in patients with chronic inflammatory disease of the airway.
Our aim was to evaluate the effects of eradication and the incidence of secondary resistance by long-term low-dose daily 14-membered-ring macrolide therapy on Helicobacter pylori ( H. pylori) infection in patients with chronic lower respiratory tract inflammatory disease. In a retrospective analysis, we studied the seroprevalence of H. pylori IgG in 90 patients with inflammation of the lower respiratory tract (68 had been treated with macrolide and 22 served as controls). Then, in a prospective analysis, we evaluated the eradication effect of macrolide therapy by the decline of IgG values and the (13)C-urea breath test. Only long-term macrolide use significantly affected the seroprevalence of H. pylori IgG. However, macrolide therapy did not reduce the H. pylori IgG values in 24 patients and did not eradicate H. pylori in (13)C-urea breath tests. Chemosensitivity testing was performed on three H. pylori strains obtained by gastric biopsy from patients in whom the disease could not be eradicated. Only one strain demonstrated a resistant character. Daily long-term low-dose 14-membered-ring macrolide therapy for patients with lower respiratory inflammatory disease may not be sufficient to eradicate H. pylori, but some strains do not acquire a resistant nature.
Respiratory Disease Center, INBAHITEC Medical Center, Nippon Medical School, Chiba, Japan. hino@fr.catv.ne.jp
Mitsunori
M
Hino
Yasushi
Y
Ono
Yutaka
Y
Kokubo
Tomoyuki
T
Soma
Yosuke
Y
Tanaka
Takashi
T
Uehara
Shoji
S
Kudoh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001944:Breath Tests; D004334:Drug Administration Schedule; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007564:Japan / Q000453:epidemiology; D018942:Macrolides / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008499:Medical Records; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D016896:Treatment Outcome; D014508:Urea / Q000378:metabolism
D000900:Anti-Bacterial Agents; D018942:Macrolides; D014508:Urea