title: Helicobacter pylori susceptibility to fosfomycin, rifampin, and 5 usual antibiotics for H. pylori eradication.
abstract: The aim of the study was to assess Helicobacter pylori resistance to fosfomycin, rifampin, and 5 other antibiotics. Susceptibility of 50 consecutive H. pylori strains was tested by E test and breakpoint susceptibility testing method. Overall and primary resistance rates were amoxicillin 2.0 and 0%, metronidazole 34.0 and 31.2%, tetracycline 2.0 and 2.1%, levofloxacin 18.0 and 16.7%, rifampin 12.0 and 10.4%, and fosfomycin 8.3 and 6.5%, respectively. Clarithromycin resistance was >20.0% in all patients (22.0%) and in untreated subjects (20.8%). Rifampin resistance was higher than those usually reported. Quinolone resistance rose from 2005-2007 (8.7%) to 2012-2013 (18.0%). High double/multidrug resistance rates (overall 22.0% and 20.0% in untreated adults), including a 5-fold resistance, were found. In conclusion, fosfomycin and rifampin resistance rates were much lower than that of metronidazole and slightly lower than those of clarithromycin and levofloxacin. MICs90 of both fosfomycin and rifampin were lower than those of clarithromycin and metronidazole. Thus, in countries of high/increasing H. pylori resistance and multidrug resistance, both rifamycins and fosfomycin could be helpful in rescue regimens.
authors.affiliation: Department of Medical Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria. Electronic address: l.boyanova@hotmail.com.
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Boyanova
authors.affiliation: Department of Gastroenterology, University Hospital St. Ekaterina, Sofia, Bulgaria; Department of General Surgery, University Hospital St. Ekaterina, Sofia, Bulgaria.
authors.forename: Lubomir
authors.initials: L
authors.lastname: Davidkov
authors.affiliation: Department of Medical Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria.
authors.forename: Galina
authors.initials: G
authors.lastname: Gergova
authors.affiliation: First Surgery Department, University Alexander Hospital, Sofia, Bulgaria.
authors.forename: Naiden
authors.initials: N
authors.lastname: Kandilarov
authors.affiliation: Department of Gastroenterology, University Hospital St. Ekaterina, Sofia, Bulgaria; Department of General Surgery, University Hospital St. Ekaterina, Sofia, Bulgaria.
authors.forename: Ivailo
authors.initials: I
authors.lastname: Evstatiev
authors.affiliation: Department of Gastroenterology, University Pediatric Hospital, Sofia, Bulgaria.
authors.forename: Emilia
authors.initials: E
authors.lastname: Panteleeva
authors.affiliation: Department of Medical Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria.
authors.forename: Ivan
authors.initials: I
authors.lastname: Mitov
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D024881:Drug Resistance, Bacterial; D005260:Female; D005578:Fosfomycin / Q000494:pharmacology*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012293:Rifampin / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D012293:Rifampin
keywords: Helicobacter pylori; antibiotic; clarithromycin; fosfomycin; levofloxacin; multidrug; resistance; rifampicin; rifampin