title: In vitro antimicrobial susceptibility of Helicobacter pylori to nine antibiotics currently used in Central Italy.
abstract: OBJECTIVE
  Helicobacter pylori expresses an increased resistance in respect to antimicrobials currently used in therapy. The aim of this study was to evaluate the antimicrobial profiles of H. pylori isolates to nine conventional antibiotics used in a Central Region (Abruzzo) of Italy.
  
  
  METHODS
  Biopsies were taken from antrum and fundus of 112 adult and 3 children with Urea Breath Test positive with dyspeptic symptoms and analyzed for H. pylori culture and antibacterial activity. Antimicrobial susceptibility tests were performed for clarithromycin, metronidazole, levofloxacin, moxifloxacin, ciprofloxacin, tetracycline, amoxicillin, ampicillin, and rifabutin by a modified agar dilution susceptibility test.
  
  
  RESULTS
  Bacterial culture was successful in 100 out of 115 patients. Helicobacter pylori strains were isolated from 98 antrum and 83 fundus samples. The rate of recovery of H. pylori strains was 90.50% (181/200). The percentages of resistance were as follows: clarithromycin 72.44% antrum, 72.28% fundus; metronidazole 34.69% antrum, 42.16% fundus; levofloxacin 42.85% antrum, 53.01% fundus; moxifloxacin 37.35% antrum, 46.57% fundus; ciprofloxacin 39.47% antrum, 44.28% fundus; tetracycline 2.63% antrum, 2.85% fundus; amoxicillin 1.02% antrum, 1.20% fundus; ampicillin 0% antrum and fundus and rifabutin 0% antrum, 1.20% fundus. A total of 35 subjects harbored multi-resistant strains.
  
  
  CONCLUSIONS
  This study underlines the high rate of resistance to clarithromycin, metronidazole and quinolones, which may reflect an overuse of them. Culture and susceptibility test, should be performed to prevent the emergence of multi-resistance and to assess an efficacious regimen.
authors.affiliation: a Department of Pharmacy , University "G. d'Annunzio" Chieti-Pescara , Chieti , Italy ;
authors.forename: Mara
authors.initials: M
authors.lastname: Di Giulio
authors.affiliation: a Department of Pharmacy , University "G. d'Annunzio" Chieti-Pescara , Chieti , Italy ;
authors.forename: Emanuela
authors.initials: E
authors.lastname: Di Campli
authors.affiliation: a Department of Pharmacy , University "G. d'Annunzio" Chieti-Pescara , Chieti , Italy ;
authors.forename: Soraya
authors.initials: S
authors.lastname: Di Bartolomeo
authors.affiliation: a Department of Pharmacy , University "G. d'Annunzio" Chieti-Pescara , Chieti , Italy ;
authors.forename: Valentina
authors.initials: V
authors.lastname: Cataldi
authors.affiliation: b Digestive Physiopathology Unit, University "G. d'Annunzio" Chieti-Pescara, Pescara Civic Hospital , Italy ;
authors.forename: Leonardo
authors.initials: L
authors.lastname: Marzio
authors.affiliation: b Digestive Physiopathology Unit, University "G. d'Annunzio" Chieti-Pescara, Pescara Civic Hospital , Italy ;
authors.forename: Laurino
authors.initials: L
authors.lastname: Grossi
authors.affiliation: b Digestive Physiopathology Unit, University "G. d'Annunzio" Chieti-Pescara, Pescara Civic Hospital , Italy ;
authors.forename: Antonio Francesco
authors.initials: AF
authors.lastname: Ciccaglione
authors.affiliation: c Department of Pharmaceutical Sciences and Health Products , University of Messina , Messina , Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: Nostro
authors.affiliation: a Department of Pharmacy , University "G. d'Annunzio" Chieti-Pescara , Chieti , Italy ;
authors.forename: Luigina
authors.initials: L
authors.lastname: Cellini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002939:Ciprofloxacin / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D004415:Dyspepsia / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology; D005748:Gastric Fundus / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007558:Italy; D064704:Levofloxacin / Q000494:pharmacology; D008297:Male; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D000077266:Moxifloxacin; D011706:Pyloric Antrum / Q000382:microbiology; D017828:Rifabutin / Q000494:pharmacology; D013752:Tetracycline / Q000494:pharmacology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D008795:Metronidazole; D017828:Rifabutin; D002939:Ciprofloxacin; D064704:Levofloxacin; D000667:Ampicillin; D000658:Amoxicillin; D013752:Tetracycline; D017291:Clarithromycin; D000077266:Moxifloxacin
keywords: Antibiotic susceptibility test; Helicobacter pylori; bacterial eradication; gastrointestinal disease; multi-drug resistance