title: Primary Antimicrobial Susceptibility Changes in Children with Helicobacter pylori Infection over 13 Years in Northern Italy.
abstract: The eradication therapy of Helicobacter pylori (H. pylori) infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is the antibiotic resistance mainly to clarithromycin. Culture from biopsies is maybe the most used method among the antimicrobial susceptibility techniques. In this study, we compared the antimicrobial susceptibility changes in children with H. pylori infection over 13 years and we confirmed that clarithromycin resistance has been increased (16% versus 26%) though with no statistically signficant value. Therefore, clarithromycin should not be used in empiric treatment of H. pylori eradication therapy in children, but its use should be limited only to children with known antimicrobial susceptibility. On the other hand, metronidazole resistance has decreased over this time period in statistically significant manner (56% versus 33%, p = 0.014). Furthermore, ampicillin resistance has been confirmed to be very rare (3% versus 0%) in children with H. pylori infection. In conclusion, in H. pylori infection, if we do not know the antibiotic susceptibility of patients, we should recommend an eradication therapy based on the local distribution of antibiotic resistance rates trying to limit the therapeutic failures.
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Marco
authors.identifier: 0000-0003-4473-1123
authors.initials: M
authors.lastname: Manfredi
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Pierpacifico
authors.initials: P
authors.lastname: Gismondi
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Maffini
authors.affiliation: Gastroenterology and Endoscopy Unit, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bizzarri
authors.affiliation: Gastroenterology and Endoscopy Unit, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Fornaroli
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Madia
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Salerno
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: A Marta
authors.initials: AM
authors.lastname: Cangelosi
authors.affiliation: Department of Pediatrics, "Pietro Barilla" Children's Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy ; Gastroenterology and Endoscopy Unit, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy.
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: de'Angelis